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Updated: Oct 23, 2025

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects
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Changes in driving performance after first and second eye cataract surgery: A driving simulator study.

Lynn B Meuleners1, Jonathon Q Ng2, Michelle L Fraser1

  • 1Western Australian Centre for Road Safety Research, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.

Journal of Safety Research
|August 17, 2021
PubMed
Summary

Cataract surgery significantly improves driving safety in older adults. Both first and second eye surgeries reduce crashes, with contrast sensitivity being a key factor in driving performance.

Keywords:
Cataract surgeryDriving performanceDriving simulatorVisual measures

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Area of Science:

  • Ophthalmology
  • Gerontology
  • Traffic Safety

Background:

  • Cataracts significantly impair vision and affect driving ability in older adults.
  • Assessing fitness to drive is crucial for public safety, particularly for elderly drivers.

Purpose of the Study:

  • To evaluate the impact of first and second eye cataract surgery on driving performance using a simulator.
  • To determine if contrast sensitivity is a better predictor of driving ability than visual acuity in cataract patients.

Main Methods:

  • A prospective cohort study of 44 drivers aged 55+ with bilateral cataracts.
  • Driving simulator assessments were conducted before first eye surgery, after first eye surgery, and after second eye surgery.
  • Generalized Estimating Equation models were used to analyze changes in driving outcomes.

Main Results:

  • Crashes/near crashes decreased by 36% after first eye surgery and 47% after second eye surgery.
  • Improved contrast sensitivity correlated with reduced crashes and less speeding.
  • Time spent speeding decreased significantly after second eye surgery.

Conclusions:

  • Timely cataract surgery, for both eyes, is essential for maintaining and improving driving safety in older adults.
  • Contrast sensitivity appears to be a more reliable indicator of driving ability than visual acuity for drivers with cataracts.