HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rubin, G. S. Search for Related Content PubMed PubMed Citation Articles by Rubin, G. S.

A Prospective, Population-Based Study of the Role of Visual Impairment in Motor Vehicle Crashes among Older Drivers: The SEE Study

¹From the Institute of Ophthalmology, University College London, United Kingdom; the ²Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom; the ³Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; ⁴Keyl Associates, East Sandwich, Massachusetts; and the ⁵Dana Center for Preventive Ophthalmology, Department of Ophthalmology, Johns Hopkins University, Baltimore, Maryland.

PURPOSE. To determine the role of vision and visual attention factors in automobile crash involvement.

METHODS. Drivers aged 65 to 84 years were identified during the baseline interview (1993–1995) of the Salisbury Eye Evaluation (SEE) Study. Crash involvement through December 1997 was determined from Maryland State motor vehicle records. Vision tests at baseline included distance acuity at normal and low luminance, contrast sensitivity, glare sensitivity, stereoacuity, and visual fields. Visual attention was evaluated with the Useful Field of View Test (UFOV; Visual Awareness, Chicago, IL). Survival analysis was used to determine the relative risk of a crash as a function of demographic variables, miles driven, vision, and visual attention.

RESULTS. One hundred twenty (6.7%) of the 1801 drivers were involved in a crash during the observation interval. Glare sensitivity and binocular field loss were significant predictors of crash involvement (P < 0.05). For those with moderate or better vision (<3 letters for glare sensitivity and <20 points missed for binocular visual fields) increased glare sensitivity or reduced visual fields were, paradoxically, associated with a reduction in crash risk, whereas for those with poorer levels of vision, increased glare sensitivity or reduced visual fields were associated with increased crash risk. Worse UFOV score was associated with increased crash risk.

CONCLUSIONS. Glare sensitivity, visual field loss, and UFOV were significant predictors of crash involvement. Acuity, contrast sensitivity, and stereoacuity were not associated with crashes. These results suggest that current vision screening for drivers’ licensure, based primarily on visual acuity, may miss important aspects of visual impairment.

This article has been cited by other articles:

				A. Kotecha, A. Spratt, and A. Viswanathan Visual function and fitness to drive Br. Med. Bull., August 20, 2008; (2008) ldn028v1. [Abstract] [Full Text] [PDF]

				V. M. F. Owen, D. P. Crabb, E. T. White, A. C. Viswanathan, D. F. Garway-Heath, and R. A. Hitchings Glaucoma and Fitness to Drive: Using Binocular Visual Fields to Predict a Milestone to Blindness Invest. Ophthalmol. Vis. Sci., June 1, 2008; 49(6): 2449 - 2455. [Abstract] [Full Text] [PDF]

				From the Library Br. J. Ophthalmol., July 1, 2007; 91(7): 988 - 988. [Full Text] [PDF]