This article reports on a study in which vision, viewing efficiency, visual attention, and on-road driving performance were assessed in 100 participants with central and/or peripheral visual field defects caused by ocular pathology. The authors investigated sensitivity and specificity of the European vision requirements for driving. The ocular pathology exhibited in the study group included visual field defects caused by age-related macular degeneration, glaucoma, or retinitis pigmentosa. The authors also considered the role of compensatory viewing strategies (such as an efficient scanning technique or eccentric viewing) in reducing the negative effect of the visual impairment. The results showed that a smaller percentage of participants with central visual field defects passed the onroad driving test, in comparison with participants with peripheral or mild field defects. The predictive power of a model based on the current vision requirements for driving significantly increased when taking compensatory viewing efficiency into account. The authors conclude that despite the increased explained variance of practical fitness to drive when taking higher-order visual functions into account, sensitivity and specificity remained quite low, limiting the use of these tests in identifying unfit drivers.
Samenvatting