title: Does correcting astigmatism with toric lenses improve driving performance?
abstract: OBJECTIVE
  Driving is a vision-based activity of daily living that impacts safety. Because visual disruption can compromise driving safety, contact lens wearers with astigmatism may pose a driving safety risk if they experience residual blur from spherical lenses that do not correct their astigmatism or if they experience blur from toric lenses that rotate excessively. Given that toric lens stabilization systems are continually improving, this preliminary study tested the hypothesis that astigmats wearing toric contact lenses, compared with spherical lenses, would exhibit better overall driving performance and driving-specific visual abilities.
  
  
  METHODS
  A within-subject, single-blind, crossover, randomized design was used to evaluate driving performance in 11 young adults with astigmatism (-0.75 to -1.75 diopters cylinder). Each participant drove a highly immersive, virtual reality driving simulator (210 degrees field of view) with (1) no correction, (2) spherical contact lens correction (ACUVUE MOIST), and (3) toric contact lens correction (ACUVUE MOIST for Astigmatism). Tactical driving skills such as steering, speed management, and braking, as well as operational driving abilities such as visual acuity, contrast sensitivity, and foot and arm reaction time, were quantified.
  
  
  RESULTS
  There was a main effect for type of correction on driving performance (p = 0.05). Correction with toric lenses resulted in significantly safer tactical driving performance than no correction (p < 0.05), whereas correction with spherical lenses did not differ in driving safety from no correction (p = 0.118). Operational tests differentiated corrected from uncorrected performance for both spherical (p = 0.008) and toric (p = 0.011) lenses, but they were not sensitive enough to differentiate toric from spherical lens conditions.
  
  
  CONCLUSIONS
  Given previous research showing that deficits in these tactical skills are predictive of future real-world collisions, these preliminary data suggest that correcting low to moderate astigmatism with toric lenses may be important to driving safety. Their merits relative to spherical lens correction require further investigation.
authors.affiliation: *PhD †OD, PhD ‡OD §BA University of Virginia Health Sciences Center, Charlottesville, Virginia (DJC, TB, JHG, RJH); and Drs. Record, Record & Adams, Optometrists, Charlottesville, Virginia (SR).
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cox
authors.forename: Thomas
authors.initials: T
authors.lastname: Banton
authors.forename: Steven
authors.initials: S
authors.lastname: Record
authors.forename: Jesse H
authors.initials: JH
authors.lastname: Grabman
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Hawkins
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000628:therapy*; D001334:Automobile Driving; D003198:Computer Simulation; D003263:Contact Lenses, Hydrophilic; D015350:Contrast Sensitivity / Q000502:physiology; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D009216:Myopia / Q000628:therapy; D011597:Psychomotor Performance / Q000502:physiology*; D016037:Single-Blind Method; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult