title: Car driving performance in hemianopia: an on-road driving study.
abstract: OBJECTIVE
  To study driving performance in people with homonymous hemianopia (HH) assessed in the official on-road test of practical fitness to drive by the Dutch driver's licensing authority (CBR).
  
  
  METHODS
  Data were collected from a cohort (January 2010-July 2012) of all people with HH following the official relicensure trajectory at Royal Dutch Visio and the CBR in the Netherlands. Driving performance during the official on-road tests of practical fitness to drive was scored by professional experts on practical fitness to drive, using the visual impairments protocol and a standardized scoring of visual, tactical and operational aspects. Age ranged from 27 to 72 years (mean = 52, SD = 11.7) and time since onset of the visual field defect ranged from 6 to 41 months (mean = 15, SD = 7.5).
  
  
  RESULTS
  Fourteen (54%) participants were judged as fit to drive. Besides poor visual scanning during driving, specific tactical, and operational weaknesses were observed in people with HH that were evaluated as unfit to drive. Results suggest that judgement on practical fitness to drive cannot be based on solely the visual field size. Visual scanning and operational handling of the car were found to be more impaired with longer time not driven, while such an effect was not found for tactical choices during driving.
  
  
  CONCLUSIONS
  Training programs aimed at improving practical fitness to drive in people with HH should focus on improving both visual scanning, as well as driving aspects such as steering stability, speed adaptation, and anticipating environmental changes.
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, The Netherlands.
authors.forename: Gera A
authors.initials: GA
authors.lastname: de Haan
authors.affiliation: Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, The Netherlands.
authors.forename: Bart J M
authors.initials: BJ
authors.lastname: Melis-Dankers
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands Department of Neurology, University Medical Center Groningen, The Netherlands.
authors.forename: Wiebo H
authors.initials: WH
authors.lastname: Brouwer
authors.affiliation: Netherlands Bureau of Driving Skills Certificates, Rijswijk, The Netherlands.
authors.forename: Ruud A
authors.initials: RA
authors.lastname: Bredewoud
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands.
authors.forename: Oliver
authors.initials: O
authors.lastname: Tucha
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, The Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: Heutink
mesh_terms: D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006423:Hemianopsia / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011597:Psychomotor Performance; D012189:Retrospective Studies; D014794:Visual Fields / Q000502:physiology*; D014796:Visual Perception / Q000502:physiology*
keywords: driving; hemianopia; patient safety; visual field defects