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Abstract
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PURPOSE: To compare on-road driving performance of patients with moderate or advanced glaucoma to controls and evaluate factors associated with unsafe driving.
DESIGN: Case-control pilot study.
METHODS: A consecutive sample of 21 patients with bilateral moderate or advanced glaucoma from Washington University, St. Louis, MO and 38 community-dwelling controls were enrolled. Participants, ages 55-90 years, underwent a comprehensive clinical evaluation by a trained occupational therapist and an on-road driving evaluation by a masked driver rehabilitation specialist. Overall driving performance of pass vs. marginal/fail and number of wheel and/or brake interventions were recorded.
RESULTS: Fifty-two percent of glaucoma participants scored a marginal/fail compared to 21% of controls (odds ratio [OR], 4.1; 95% CI, 1.30-13.14;p=.02). Glaucoma participants had a higher risk of wheel interventions than controls (OR, 4.67; 95% CI, 1.03-21.17;p=.046). There were no differences detected between glaucoma participants who scored a pass vs. marginal/fail for visual field mean deviation of the better (p=.62) or worse (p=.88) eye, binocular distance (p=.15) or near (p=.23) visual acuity, contrast sensitivity (p=.28) or glare (p=.88). However, glaucoma participants with a marginal/fail score performed worse on Trail Making Tests A (p=.03) and B (p=.05), right-sided Jamar grip strength (p=.02), Rapid Pace Walk (p=.03), Braking Response Time (p=.03), and identifying traffic signs (p=.05).
CONCLUSIONS AND RELEVANCE: Patients with bilateral moderate or advanced glaucoma are at risk for unsafe driving - particularly those with impairments on psychometric and mobility tests. A comprehensive clinical assessment and on-road driving evaluation is recommended to effectively evaluate driving safety of these patients.
Copyright © 2015 Elsevier Inc. All rights reserved.
Language: en |