[Driving habits of patients with glaucoma].
BACKGROUND
Central visual field defects due to glaucoma are common, increasing with old age. Impaired visual processing, for instance caused by glaucoma, may play a role in the aetiology of car accidents involving older drivers which can result in personal injury. Mandatory eye exams with assessment of the visual field in elderly people holding a driving licence will become more and more important, especially in a continuously ageing and increasingly mobile population.


METHODS
In this prospective study, 80 patients with overt glaucoma and 52 patients without glaucoma, all holders of a valid driving licence, were enrolled. For each patient, the best corrected visual acuity was recorded and an examination of the central visual field was performed with automatic perimetry. In addition, a detailed questionnaire about the current driving habits of the patient was requested.


RESULTS
In summary, 29 patients (36 %; 95 % CI: 26 - 48 %) of 80 glaucoma patients were driving a motor vehicle with binocular congruent scotomata within the central 30 degrees visual field, which is not sufficient to meet current legal requirements in Austria. In addition, 3 out of 29 impaired patients had a visual acuity that was below the mandatory legal requirements. A total of 39 patients (49 %; 95 % CI: 37 - 60 %) of the glaucoma patients fulfilled legal requirements. Examination of these patients showed only monocular or binocular central visual field defects that were not congruent. However, 12 (15 %; 95 % CI: 8 - 25 %) patients were holders of a valid driving licence, but had stopped driving some time ago. Based on the prevalence of glaucoma and the number of driving licence holders, the projected number of actively driving glaucoma patients who do not meet the legal requirements regarding the visual field is probably around 15,400 (7,400 - 29,500) in Austria and around 163,500 (79,000 - 313,500) in Germany.


CONCLUSIONS
Time limits for the validity of the driving licence within the European Community have been set. In addition, the legal requirements for driving a motor vehicle should also be clearly defined, especially the requirements regarding the visual field and the acceptable dimensions of central scotomata. In addition, a mandatory eye exam for older drivers to be performed by ophthalmologists should be considered in order to detect persons posing a safety risk in traffic.
Nischler
C
C
Universitätsklinik für Augenheilkunde und Optometrie, Paracelsus Medizinische Privatuniversität Salzburg. c.nischler@salk.at
Emesz
M
M
Hufnagl
C
C
Marvan
P
P
Hornykewycz
K
K
Stöllinger
M
M
Grabner
G
G
Hitzl
W
W
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001317:Austria / Q000453:epidemiology; D001333:Automobile Driver Examination / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D001334:Automobile Driving / Q000331:legislation & jurisprudence / Q000592:standards* / Q000706:statistics & numerical data*; D015897:Comorbidity; D005062:European Union; D005260:Female; D005901:Glaucoma / Q000453:epidemiology*; D019983:Guideline Adherence / Q000331:legislation & jurisprudence / Q000592:standards / Q000706:statistics & numerical data; D006184:Habits; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000453:epidemiology*; D014792:Visual Acuity