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Updated: Sep 7, 2026
Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects
Published on: September 18, 2012
Clinical Validation of a Comprehensive Vision Screener for Assessing Visual Fitness for Drivers in Mumbai, India
Mumtaz Qazi1, Prema K Chande1, Neha Dattatray Jadhav1
1Lotus College of Optometry, Lotus Eye Hospital, Mumbai, Maharashtra, India.
Purpose:
To determine the agreement of an all-in-one portable vision screener (VS) with a standard battery of optometrist-administered tests. The purpose is to understand the feasibility of rapid screening for visual functions before providing occupational visual fitness.
Patients And Methods:
A Prospective cross-sectional study was performed among licensed public transport drivers at community eye camps in Mumbai. Distance and near vision, contrast sensitivity (CS), stereopsis, colour vision (CV), and peripheral visual field were assessed using standard tests, including the LogMAR, Titmus Fly, Ishihara, and confrontation test, respectively. The same assessments were repeated using an all-in-one portable screener (VS). The total testing time was recorded for each test. Receiver Operating Characteristic (ROC) curves and Bland-Altman plots were used for statistical analyses.
Results:
A total of 384 drivers participated, with a mean age of 47.1 ± 9.14 years. The mean presenting distance visual acuity was 0.22 ± 0.16 and 0.20 ± 0.18 LogMAR (p>0.05), the mean values for CS were 2.98 ± 2% and 5.7 ± 10.17% (p<0.05), the values for stereopsis were 863.08 ± 1402.92 and 656.54 ± 933.29 sec of arc (p<0.05) with standard charts and VS, respectively. The integrated colour vision test demonstrated low sensitivity (22.2%) but high specificity (89.2%) for detecting colour vision deficiency. Screening time decreased from 20 ± 5 minutes to 7 ± 3 minutes. ROC analysis showed excellent diagnostic accuracy for distance visual acuity (AUC = 0.861) and modest discriminative ability for stereopsis (AUC = 0.653). Bland-Altman analysis indicated good agreement between the standard test and screener for vision, CS, and stereopsis, with no significant systematic bias.
Conclusion:
The portable vision screener demonstrated high accuracy and strong agreement with standard clinical tests for visual functional tests. It enables rapid, comprehensive assessment of visual functions, making it a practical tool for large-scale vision screening in OHCs or mobile eye screening camps.
