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Binocular Visual Field Loss and Crash Risk: An eFOVID Population-Based Study
Siobhan Manners1, Lynn B Meuleners2, Jonathon Q Ng1
1School of Population and Global Health, The University of Western Australia, Perth, Australia.
Ophthalmic Epidemiology
|December 18, 2024
Summary
Visual field loss in older drivers significantly increases crash risk. Even mild loss elevates odds by 84%, with severe loss in specific quadrants nearly doubling the risk, highlighting the need for driving guidelines.
Area of Science:
- Ophthalmology and Public Health
- Geriatric Medicine
- Road Safety Research
Background:
- Visual field loss significantly impacts daily activities, particularly driving, for individuals aged 50 and above.
- Existing evidence on the link between visual field loss and motor vehicle crash risk is inconsistent.
- This study addresses the need for clearer data on how visual field deficits affect driving safety in older adults.
Purpose of the Study:
- To investigate the association between the severity and location of binocular visual field loss and motor vehicle crashes in older adults (50+).
- To provide objective evidence for developing 'fitness to drive' guidelines for elderly drivers.
- To assess the utility of linking ophthalmic databases with crash records for road safety research.
Main Methods:
- Utilized a comprehensive database of visual field tests from Western Australian ophthalmologists (1990-2019).
- Classified visual field deficits into three severity levels across five distinct regions.
- Linked ophthalmic data with government administrative databases, including motor vehicle crash records.
Main Results:
- A total of 31,296 individuals were included, with 4,307 (13.76%) older drivers involved in 5,537 crashes.
- Binocular visual field loss, irrespective of severity or location, was associated with an 84% increased odds of a crash (OR 1.84).
- Severe visual field loss in specific quadrants demonstrated a substantial increase in crash odds: upper left (98%), lower left (97%), lower right (89%), and upper right (95%).
Conclusions:
- Binocular visual field loss, even when not severe or localized to specific areas, significantly elevates the risk of motor vehicle crashes in older drivers.
- Specific locations and severity of visual field loss pose considerable threats to safe driving.
- Linking large ophthalmic databases with crash records offers a robust method for informing 'fitness to drive' assessments and guidelines for older drivers.
