The driving visual field and a history of motor vehicle collision involvement in older drivers: a population-based examination.
OBJECTIVE
We designed a visual field test focused on the field utilized while driving to examine associations between field impairment and motor vehicle collision involvement in 2000 drivers aged 70 years or older.


METHODS
The "driving visual field test" involved measuring light sensitivity for 20 targets in each eye, extending 15° superiorly, 30° inferiorly, 60° temporally, and 30° nasally. The target locations were selected on the basis that they fell within the field region utilized when viewing through the windshield of a vehicle or viewing the dashboard while driving. Monocular fields were combined into a binocular field based on the more sensitive point from each eye. Severe impairment in the overall field or a region was defined as average sensitivity in the lowest quartile of sensitivity. At-fault collision involvement for 5 years prior to enrollment was obtained from state records. Poisson regression was used to calculate crude and adjusted rate ratios (RRs) examining the association between field impairment and at-fault collision involvement.


RESULTS
Drivers with severe binocular field impairment in the overall driving visual field had a 40% increased rate of at-fault collision involvement (RR, 1.40; 95% confidence interval [CI]: 1.07-1.83). Impairment in the lower and left fields was associated with elevated collision rates (RR, 1.40; 95% CI: 1.07-1.82 and RR, 1.49; 95% CI: 1.15-1.92, respectively), whereas impairment in the upper and right field regions was not.


CONCLUSIONS
Results suggest that older drivers with severe impairment in the lower or left region of the driving visual field are more likely to have a history of at-fault collision involvement.
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Carrie
C
Huisingh
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Gerald
G
McGwin
School of Optometry and Vision Science and Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
Joanne
J
Wood
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Cynthia
C
Owsley
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000592:standards*; D015350:Contrast Sensitivity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*
aging; driving; visual field