Hazard Perception in Older Drivers With Eye Disease

Timely detection of hazards is a key driving skill; however, the hazard perception of drivers with eye disease and related visual changes and the visual predictors of hazard perception are poorly understood.

Participants included drivers aged 65 years and older with a range of eye diseases, including cataract, age-related maculopathy (AMD), and glaucoma (n = 99; mean age, 75.4 ± 6.4 years) and controls (n = 118; mean age, 72.2 ± 5.5 years). Visual performance was assessed using clinical measures (visual acuity, contrast sensitivity, visual fields) and non-clinical measures (useful field of view, motion sensitivity). Participants completed a computer-based hazard perception test (HPT) that has been related to driving performance and crash risk.

Participants with eye disease exhibited a 0.73-second delay in HPT response times compared to controls (6.61 ± 1.62 seconds vs. 5.88 ± 1.38 seconds; age-adjusted P = 0.012). Participants with glaucoma exhibited significantly delayed responses compared to those with AMD (P = 0.038) and controls (P = 0.004). Poorer motion sensitivity (standardized β = 0.27; P < 0.001), visual acuity (β = 0.21; P = 0.002), and better-eye mean defect (β = -0.17; P = 0.009) were most strongly associated with delayed HPT responses. Motion sensitivity remained significantly associated with HPT responses, adjusted for visual acuity and visual fields.

HPT responses of older drivers with eye disease were delayed compared to controls and translate to an estimated 16-meter longer stopping distance when traveling at 80 km/hr. Decreased motion sensitivity was most strongly associated with delayed HPT responses.

HPT tests can provide insight into difficulties regarding road hazard detection of older drivers with eye disease and provide a potential avenue for interventions to improve road safety.