Assessment of driving safety in non-professional drivers with moderate to severe glaucoma

The purpose of this paper is to assess driving safety in non-professional drivers who have moderate to severe glaucoma.

Cross-sectional analytical study.

It is a hospital-based study conducted in a multispecialty tertiary care institute.

Fifty-five patients (110 eyes) above 40 years of age with moderate to severe glaucoma as per Hodapp-Anderson-Parrish classification, having a valid driving license (for at least one year).

Enrollees underwent a comprehensive clinical assessment along with contrast sensitivity (CS) testing with Pelli-Robson chart and binocular field testing with Esterman visual field test (EVFT). The driving habits questionnaire was administered, and driving eligibility was compared to international guidelines.

Patients having moderate to severe glaucoma as well as poor CS experience significant driving-related difficulties, have reduced driving space, and are more dependent on others for mobility.

The mean age (years) was 61.42 ± 10.17 with a significant male preponderance (98.2%). The study population included 47.3% moderate and 52.7% advanced glaucoma patients. Twenty-two patients (40%) had CS less than 2.00 in their worse eye (mean: 1.93; Standard deviation (SD): 0.27; range: 1.4-2.3), out of which five had moderate glaucoma and seventeen had severe glaucoma. Only two patients with advanced glaucoma had CS <1.5 (visual impairment). Around half of the participants (30/55; 54.5%) passed the EVFT. The driving dependency score (mean ± SD) was 1.78 ± 0.92 (range: 1.0-3.0), driving difficulty score (mean ± SD) was 69.38 ± 20.43 (range: 0-100), and driving space score (mean ± SD) was 3.15 ± 0.85 (range: 0-6).

Patients with moderate to advanced glaucoma with reduced CS face significant difficulties while driving. It is necessary to establish precise rules regarding vision standards for driving license issues and renewal in India so that motor vehicle accidents can be prevented due to vision-related impairments.