Influence of age, speed and duration of monotonous driving task in traffic on the driver's useful visual field

Recent research has shown that the useful visual field deteriorates in simulated car driving when the latter can induce a decrease in the level of activation. The first aim of this study was to verify if the same phenomenon occurs when driving is performed in a simulated road traffic situation. The second aim was to discover if this field also deteriorates as a function of the driver's age and of the vehicle's speed. Nine young drivers (from 22 to 34 years) and nine older drivers (from 46 to 59 years) followed a vehicle in road traffic during two two-hour sessions. The car-following task involved driving at 90 km.h(-1) (speed limit on road in France) in one session and at 130 km.h(-1) (speed limit on motorway in France) in the other session. While following the vehicle, the driver had to detect the changes in colour of a luminous signal located in the central part of his/her visual field and a visual signal that appeared at different eccentricities on the rear lights of the vehicles in the traffic. The analysis of the data indicates that the useful visual field deteriorates with the prolongation of the monotonous simulated driving task, with the driver's age and with the vehicle's speed. The results are discussed in terms of general interference and tunnel vision.     

Useful visual field reduction as a function of age and risk of accident in simulated car driving

PURPOSE: To study the relationships between the reduction of the useful visual field, age, and driving performance. METHODS: Forty-eight subjects, aged from 23 to 77 years performed a test to evaluate the size of their useful visual fields. The test involved the detection and localization of peripheral signals that could appear in an area of 70 degrees of visual angle. The subjects then performed a simulated car-driving task involving the management of a situation that could lead to an accident. RESULTS: The analysis of the data revealed that the ability to process peripheral signals and simulated driving performance (vehicle speed) deteriorate with age. Simulated driving performance and useful visual field measurement have been analyzed jointly. The results indicate that the reduction of the useful visual field, estimated using a target-localization task, is related to the individual's ability to manage the simulated driving situation (correlation coefficient with speed = -0.43 and with reaction time for avoidance of a mobile obstacle = +0.30) and the deterioration of the useful visual field estimated using a target detection task is related only to vehicle speed (correlation coefficient = -0.32). CONCLUSIONS: The adoption of a lower speed by the drivers with a reduced visual field (the elderly ones) is probably an adaptation strategy to process the peripheral information. All useful visual field measurements do not seem to be equivalent to estimate the ability to process information relative to the mobile obstacle. The risk of collision should be estimated only with a useful visual field test using a target localization task.     

Relation between perceived driving disability and scores of vision screening tests

AIM: To determine the relation between perceived driving disability and vision screening tests. METHODS: 93 subjects, aged 50 years and over, with binocular visual acuity of at least 20/80. Perceived driving disability (PDD) was assessed by a questionnaire. Subtracting daytime from night-time driving question scores revealed PDD at night (PDDN), subtracting scores of questions for driving in familiar places from those in unfamiliar places revealed PDD at unfamiliar places (PDDU). RESULTS: PDD was strongly related to visual acuity, contrast sensitivity and useful field of view (UFOV). Specific relations existed between PDDN and Nyktotests and Mesotests and between PDDU and UFOV. These associations were enhanced in a subset of subjects with better visual acuities. CONCLUSIONS: Vision screening tests correlate well with perceived driving disabilities, especially when a subtraction method is used in the questionnaire to reveal condition dependent disabilities. Additional tests for visual acuity are useful, especially in subjects with better visual acuity.     

The effect of visual field defects on eye movements and practical fitness to drive

Eye movements of subjects with visual field defects due to ocular pathology were monitored while performing a dot counting task and a visual search task. Subjects with peripheral field defects required more fixations, longer search times, made more errors, and had shorter fixation durations than control subjects. Subjects with central field defects performed less well than control subjects although no specific impairment could be pinpointed. In both groups a monotonous relationship was observed between the visual field impairment and eye movement parameters. The use of eye movement parameters to predict viewing behavior in a complex task (e.g. driving) was limited.     

Glare disability and driving safety

PURPOSE: Increasing investigation of the visual elements of safe driving environments may be of great benefit to society. Visual disability appears to be only one of many visual factors related to traffic accidents. The purpose of this article was to examine the type of visual impairment mediated by the increased glare sensitivity in adult drivers using the original halometer glare test. METHODS: In this article, the visual sensory, cognitive and motor functions relevant to driving, their measurement, the epidemiology and prevention of age-associated functional impairments and the relationship of functional impairments to both self-reported driving and the imposition of legal restrictions are reviewed. RESULTS: The problem of night and tunnel driving is the most urgent in relation to the effects of glare from vehicle headlights on motion perception of drivers. The reduced mesopic vision and increased sensitivity to glare are accompanied by an increased risk of nighttime accidents. Elderly drivers and patients with beginning cataract cannot sufficiently fulfill the criteria for night driving ability because of contrast and glare sensitivity. It is indispensable for the parameters mentioned to be carefully measured and for drivers to be informed that night driving ability may be impaired, even if visual acuity is sufficient. CONCLUSIONS: It would be advisable for traffic safety if simple tests for contrast and glare sensitivity were implemented for vehicles and/or were regularly added to the requirements for a driver's licence, at least for older drivers. The age, functional status and test result limits should be defined to avoid a risk factor in traffic.     

Effects of age and auditory and visual dual tasks on closed-road driving performance.

PURPOSE: This study investigated how driving performance of young and old participants is affected by visual and auditory secondary tasks on a closed driving course. METHODS: Twenty-eight participants comprising two age groups (younger, mean age = 27.3 years; older, mean age = 69.2 years) drove around a 5.1-km closed-road circuit under both single and dual task conditions. Measures of driving performance included detection and identification of road signs, detection and avoidance of large low-contrast road hazards, gap judgment, lane keeping, and time to complete the course. The dual task required participants to verbally report the sums of pairs of single-digit numbers presented through either a computer speaker (auditorily) or a dashboard-mounted monitor (visually) while driving. Participants also completed a vision and cognitive screening battery, including LogMAR visual acuity, Pelli-Robson letter contrast sensitivity, the Trails test, and the Digit Symbol Substitution (DSS) test. RESULTS: Drivers reported significantly fewer signs, hit more road hazards, misjudged more gaps, and increased their time to complete the course under the dual task (visual and auditory) conditions compared with the single task condition. The older participants also reported significantly fewer road signs and drove significantly more slowly than the younger participants, and this was exacerbated for the visual dual task condition. The results of the regression analysis revealed that cognitive aging (measured by the DSS and Trails test) rather than chronologic age was a better predictor of the declines seen in driving performance under dual task conditions. An overall z score was calculated, which took into account both driving and the secondary task (summing) performance under the two dual task conditions. Performance was significantly worse for the auditory dual task compared with the visual dual task, and the older participants performed significantly worse than the young subjects. CONCLUSIONS: These findings demonstrate that multitasking had a significant detrimental impact on driving performance and that cognitive aging was the best predictor of the declines seen in driving performance under dual task conditions. These results have implications for use of mobile phones or in-vehicle navigational devices while driving, especially for older adults.     

On-road driving with moderate visual field loss.

PURPOSE: We examined the relationship between visual field extent and driving performance in an open, on-road environment using a detailed scoring method that assessed the quality of specific skills for a range of maneuvers. The purpose was to determine which maneuvers and skills should be included in future, larger scale investigations of the effect of peripheral field loss on driving performance. METHODS: Twenty-eight current drivers (67 +/- 14 years) with restricted peripheral visual fields participated. Binocular visual field extent was quantified using Goldmann perimetry (V4e target). The useful field of view (UFOV) and Pelli-Robson letter contrast sensitivity tests were administered. Driving performance was assessed along a 14-mile route on roads in the city of Birmingham, Alabama. The course included a representative variety of general driving maneuvers, as well as maneuvers expected to be difficult for people with restricted fields. RESULTS: Drivers with more restricted horizontal and vertical binocular field extents showed significantly (p < or = 0.05) poorer skills in speed matching when changing lanes, in maintaining lane position and keeping to the path of the curve when driving around curves, and received significantly (p < or = 0.05) poorer ratings for anticipatory skills. Deficits in UFOV performance and poorer contrast sensitivity scores were significantly (p < or = 0.05) correlated with overall driving performance as well as specific maneuver/skill combinations. CONCLUSIONS: In a small sample of drivers, mild to moderate peripheral visual field restrictions were adversely associated with specific driving skills involved in maneuvers for which a wide field of vision is likely to be important (however most were regarded as safe drivers). Further studies using similar assessment methods with drivers with more restricted fields are necessary to determine the minimum field extent for safe driving.     

Measures of visual function and their association with driving modification in older adults

PURPOSE: Older drivers may place restrictions on their driving by reducing their mileage and avoiding high-risk driving situations in an effort to improve safety. This project identifies what types of visual function loss are associated with subsequent driving modifications. METHODS: Data were used from the baseline and 2-year follow-up rounds of the Salisbury Eye Evaluation project, a cohort study of 2520 older adults. Measures of visual function tested were visual acuity, contrast sensitivity, visual fields, and glare sensitivity. Driving information was self-reported. Among drivers at baseline who continued to drive at follow-up, multiple logistic regression was used to estimate the odds of incident driving modification by visual function status. RESULTS: Worse baseline scores in acuity, contrast sensitivity, and central and lower peripheral visual fields were individually associated with an increased odds of reduced mileage 2 years later (linear trend P < 0.05). Worse baseline scores in contrast sensitivity and central and lower peripheral visual fields were individually associated with a greater odds of cessation of night driving 2 years later, whereas worse baseline acuity scores were associated with an increased odds of cessation of driving in an unfamiliar areas 2 years later (linear trend P < 0.05). CONCLUSIONS: Older drivers with worse visual function were more likely to modify their driving by reducing mileage and avoiding high-risk driving situations. Furthermore, these modifications to driving differed depending on what type of visual function was affected.     

视力及视野损害与交通事故

视力和视野是安全驾驶的必要条件.各国获取驾驶执照对视力和视野要求不同,但大多数国家视力标准为双眼视力不能低于0.5,水平视野为120°.在过去20年里,大量的研究关注视觉在驾驶中所起的作用,视觉损害对发生交通事故的影响.较早期的研究证明,视觉损害可使事故增加,视觉与事故有明显的相关性.但近期大量的研究认为较好视觉与较差视觉相比事故发生率无差别,因而认为视觉与交通事故无明显相关.上述两种研究结果互相矛盾,可能是由于安全驾驶是需要人、车及环境因素成功地整合及参与才能完成.因此,建议今后关于安全驾驶的研究除视觉外,尚需考虑其他因素.     

Visual characteristics of elderly night drivers in the salisbury eye evaluation driving study

Purpose. To characterize visual factors among those who continue to drive and those who restrict night driving in the elderly population. Methods. The Salisbury Eye Evaluation Driving Study (SEEDS) is a study of vision, cognition, and driving behaviors of older drivers living in the greater Salisbury, Maryland, metropolitan area. Patients were recruited from listings in the Department of Motor Vehicle Administration. Data are reported from two visits conducted 2 years apart. Night driving was assessed using a real-time driving assessment tool, the Driving Monitor System. Night driving was defined by the presence of at least one episode of driving at night during a 5-day time period (seasonally adjusted). Participants also underwent a battery of cognitive and visual function testing including distance acuity, contrast sensitivity, and visual fields. Logistic regression was used to model factors associated with night driving. Results. Complete data were available for 990 of the 1080 participants (92%) attending both visits; 41% of participants were driving at night in each visit. Those who were younger (P < 0.001), male (P < 0.001), and had better measures of cognitive (P = 0.007) and visual function were observed driving at night, whereas those who were older, female, and had poorer measures of cognitive and visual function restricted their night driving behavior. An association was observed between depressive symptoms and less night driving in females (P = 0.003). In multivariate analysis, better contrast sensitivity (odds ratio [OR] 1.18, 95% confidence interval [CI] 1.02-1.36, P = 0.02) and visual field detection (OR 1.21, 95% CI 1.00-1.47, P = 0.05) were associated with driving at night. Visual acuity was not found to be significantly related to night driving (OR 1.08, 95% CI 0.95-1.18, P = 0.12). Conclusions. Restricting driving at night is a multifactorial behavior that has a vision component, notably poor contrast sensitivity, and some loss of visual fields.     

Peripheral vision screening for driving in retinitis pigmentosa patients

The authors evaluated the test protocols used most frequently to screen the peripheral visual field of driving applicants to determine whether they are suitable for detecting peripheral field loss in patients with retinitis pigmentosa (RP). The peripheral vision tests available on the Keystone View Tester and the Titmus Vision Tester were administered to 23 subjects with RP, 3 subjects with Type 2 Usher's syndrome, and 1 subject who was a partially affected carrier of X-linked recessive RP. The subjects had varying degrees and types of visual field loss. Tests were administered using the standard protocol of the State of Illinois, which is a standard procedure used by state licensing bureaus nationwide. Results demonstrate that the screening protocols use stimulus conditions that are primarily sensitive only to appreciable field losses and examine locations that typically lie within an RP patient's remaining visual field rather than at locations that characteristically are scotomatous. The authors suggest that the current test protocols could determine peripheral field impairment more accurately by assessing additional locations in the visual field, and by introducing a background field and/or by reducing the luminance of the test targets.     

Visual Difficulty Driving at Night

ABSTRACT Two thousand drivers attending for optometric examination were asked if they drove at night and if they had visual difficulty driving at night. One quarter of the sample reported visual difficulty driving at night and one quarter of this group elected not to drive at night for this reason. The proportion of drivers reporting visual difficulty driving at night was not related to age for subjects aged less than 70 years. Significantly more women than men reported visual difficulty driving at night and more women than men elected not to drive at night. The proportion of drivers reporting visual difficulty driving at night and the proportion electing not to drive at night is strongly related to visual acuity. However despite some drivers with lowered visual acuity deciding not to drive at night the proportion of drivers with lowered visual acuity would not be greatly reduced at night.     

The role of retinal adaptation in night driving.

PURPOSE: Driving is essentially a visuomotor task, and there is now compelling evidence that the disproportionate number of road accidents under night driving conditions is linked to changes in visual performance resulting from reduced lighting. The objective of this article is to establish the extent to which vision is either rod-or cone-dominated under night driving conditions. METHODS: Visual thresholds are measured under lighting conditions that simulate urban lighting. Dark adaptation curves are obtained under three ambient lighting conditions ranging from low (0.1 cd/m) to high (5 cd/m) mesopic levels of retinal adaptation using circular discs of different sizes (1 degree, 2 degrees, 3 degrees, and 5 degrees) presented at retinal eccentricities of 0 degrees, 10 degrees, 20 degrees, 30 degrees, and 40 degrees. RESULTS: The dark adaptation curves exhibit the classic inflection point between rod and cone activity for the lower levels of ambient illumination but a simple monophasic function for the high mesopic levels (>0.5 lux). Adaptation rates are four times faster for the higher compared with the lower illumination level and twice as fast for central compared with peripheral presentation. CONCLUSIONS: The data suggest that vision is mediated by cone pathways at 5 lux and by rod pathways at 0.5/0.1 lux. This shift does not profoundly affect sensitivity, but because rod pathways are known to be slower than cone pathways, it will certainly affect observers' ability to respond to rapidly changing viewing conditions such as are encountered when driving at night.     

Night driving self-restriction: vision function and gender differences.

PURPOSE: The purpose of this study was to evaluate gender differences in the relationship between night driving self-restriction and vision function in an older population. METHODS: Night driving self-restriction patterns (assessed by questionnaire) were examined cross-sectionally in relation to age, gender, health and cognitive status, depression, and vision function in a sample of 900 elders (mean age, 76 years) living in Marin County, California. RESULTS: Of the total sample, 91% of men and 77% of women were current drivers. The mean age of the drivers was 73.3 years (range, 58-96 years). Among current drivers, women had slightly better vision function than men on most measures (low-contrast acuity, contrast sensitivity, low-contrast acuity in glare, low-contrast, low-luminance acuity, and glare recovery) but were twice as likely as men to restrict their driving to daytime. Men showed significant associations with avoidance of night driving on four spatial vision measures (high- and low-contrast acuity, low-contrast, low-luminance acuity, and contrast sensitivity). For women, in addition to these measures, a significant association was seen for low-contrast acuity in glare. Neither men nor women showed significant associations between driving restriction and performance on the other vision measures examined (glare recovery time, attentional field integrity, or stereopsis). The vision measures most predictive of self-restriction were contrast sensitivity for men and low-contrast acuity in glare for women. CONCLUSIONS: Including both cessation and self-restriction, men over age 85 years are 6.6 times more likely than women to be driving at night. For both genders, vision plays a significant role in the self-restriction decision. A higher percentage of men than women continue to drive at night with poor vision. Men's night-driving cessation was associated with contrast sensitivity and depression, whereas women's night-driving cessation was associated with low-contrast acuity in glare as well as age.     

Effect of restriction of the binocular visual field on driving performance

The importance of the visual field on driving performance was investigated. This was undertaken by simulating binocular visual field defects for a group of young normal subjects and assessing the impact of these defects on performance on a driving course. Constriction of the binocular visual field to 40 or less, significantly increased time taken to complete the course, reduced the ability to detect and correctly identify road signs, avoid obstacles and to manoeuvre through limited spaces. Accuracy of road positioning and reversing were also impaired. Constriction of the binocular visual field did not significantly affect speed estimation, stopping distance, or the time taken for the reversing and manoeuvring tasks. The monocular condition did not significantly affect performance for any of the driving tasks assessed.     

Central and paracentral visual field defects and driving abilities

The effect of central and paracentral visual field defects on driving abilities has until now received little attention. To date studies and surveys have concentrated on visual acuity and peripheral field loss. Here we summarise for the first time those diseases causing central visual field defects likely to be associated with binocular visual acuity adequate for driving.     

Visual field assessment and the Austroads driving standard

Purpose: To compare the conventional (Humphrey 24‐2) automated visual field testing with the Goldmann standard visual field test for driving, and to predict how many patients with glaucoma may not meet the Australian driving standard with respect to visual fields. Methods: Four patients (retinitis pigmentosa, glaucoma or vigabatrin treatment) with marked visual field defects as determined by uniocular static computerized perimetry (conventional testing) were re‐evaluated with binocular kinetic Goldmann IV4e target field test (Australian driving standard). A series of 48 consecutive patients seen by the Glaucoma Inheritance Study in Tasmania were assessed with both static computerized perimetry and the Goldmann IV4e target test. Results: The four patients with severe visual field defects (on computerized perimetry) were found to meet the driving standard on the binocular Goldmann IV4e target test. On computerized perimetry, 15 of 48 patients from the Glaucoma Inheritance Study in Tasmania were found to have visual field defects of sufficient severity that they may not meet the driving standard. However, only five of these patients failed the driving standard for visual fields, two of whom were still driving. Conclusions: Patients with severe field defects on conventional uniocular automated perimetry may still meet the Goldmann standard visual field test for driving. Approximately 30% of glaucoma patients would have visual field loss shown on Humphrey 24‐2 test of a severity that requires further testing to determine if they meet the driving standard. Ten per cent of glaucoma patients tested did not meet the driving standard for visual fields.     

Interaction between visual status, driver age and distracters on daytime driving performance

This study investigated the effects of visual status, driver age and the presence of secondary distracter tasks on driving performance. Twenty young (M = 26.8 years) and 19 old (M = 70.2 years) participants drove around a closed-road circuit under three visual (normal, simulated cataracts, blur) and three distracter conditions (none, visual, auditory). Simulated visual impairment, increased driver age and the presence of a distracter task detrimentally affected all measures of driving performance except gap judgments and lane keeping. Significant interaction effects were evident between visual status, age and distracters; simulated cataracts had the most negative impact on performance in the presence of visual distracters and a more negative impact for older drivers. The implications of these findings for driving behaviour and acquisition of driving-related information for people with common visual impairments are discussed.     

Action video game players and deaf observers have larger Goldmann visual fields

We used Goldmann kinetic perimetry to compare how training and congenital auditory deprivation may affect the size of the visual field. We measured the ability of action video game players and deaf observers to detect small moving lights at various locations in the central (around 30° from fixation) and peripheral (around 60°) visual fields. Experiment 1 found that 10 habitual video game players showed significantly larger central and peripheral field areas than 10 controls. In Experiment 2 we found that 13 congenitally deaf observers had significantly larger visual fields than 13 hearing controls for both the peripheral and central fields. Here the greatest differences were found in the lower parts of the fields. Comparison of the two groups showed that whereas VGP players have a more uniform increase in field size in both central and peripheral fields deaf observers show non-uniform increases with greatest increases in lower parts of the visual field.     

Visual function tests, eye disease and symptoms of visual disability: a population-based assessment

Purpose : To examine associations between eye disease and tests of visual function with self‐reported visual disability. Methods : The Blue Mountains Eye Study is a cross‐sectional census‐based survey of eye disease in two postcode areas in the Blue Mountains, west of Sydney, Australia. Of 4433 eligible residents, 3654 (82.4%) participated. Subjects had a detailed eye examination, including tests of visual acuity, contrast sensitivity, disability glare and visual field. Lens and retinal photographs were taken and graded according to standardized protocols for presence of cataract, early and late age‐related maculopathy, glaucoma, diabetic retinopathy, retinal vein occlusion and other eye diseases. An interviewer‐administered questionnaire included questions about perception of visual disability. Results : Scores on all tests of visual function significantly decreased with age (P < 0.0001). This decrease persisted for all tests except disability glare after excluding subjects with identifiable eye disease. The presence of one or more eye diseases was significantly associated with all (self‐reported) measures of visual disability (trouble driving at night, difficulty recognizing a friend across the street, reading a newspaper or recognizing detail on television); mixed cataract (cortical and nuclear, or posterior subcapsular and nuclear) was associated with trouble driving at night and difficulty recognizing a friend across the street. A 10‐letter (two‐line) decrease in best corrected or presenting visual acuity was significantly associated with all self‐reported measures of visual disability, as was a two‐step decrease in contrast sensitivity. A five‐point increase in points missing in the visual field was weakly but significantly associated with all self‐reported measures of visual disability except trouble driving at night. Conclusions : Visual function declines with age. Impaired visual function was strongly, and eye disease relatively weakly associated with reports of visual disability.