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Boadi-Kusi SB, Aikins PM, Zaabaar E, Duku AG. Visual function correlates of self-reported vision-related nighttime driving difficulties. JOURNAL OF OPTOMETRY 2024; 17:100506. [PMID: 38128433 PMCID: PMC10777108 DOI: 10.1016/j.optom.2023.100506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/04/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To investigate the visual function correlates of self-reported vision-related night driving difficulties among drivers. METHODS One hundred and seven drivers (age: 46.06 ± 8.24, visual acuity [VA] of 0.2logMAR or better) were included in the study. A standard vision and night driving questionnaire (VND-Q) was administered. VA and contrast sensitivity were measured under photopic and mesopic conditions. Mesopic VA was remeasured after introducing a peripheral glare source into the participants' field of view to enable computation of disability glare index. Regression analyses were used to assess the associations between VND-Q scores, and visual function measures. RESULTS The mean VND-Q score was -3.96±1.95 logit (interval scale score: 2.46±1.28). Simple linear regression models for photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index significantly predicted VND-Q score (P<0.05), with mesopic VA and disability glare index accounting for the greatest variation (21 %) in VND-Q scores followed by photopic contrast sensitivity (19 %), and mesopic contrast sensitivity (15 %). A multiple regression model to determine the association between the predictors (photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index) and VND-Q score yielded significant results, F (4, 102) = 8.58, P < 0.001, adj. R2 = 0.2224. Seeing dark-colored cars was the most challenging vision task. CONCLUSION Changes in mesopic visual acuity, photopic and mesopic contrast sensitivity, as well as disability glare index are associated with and explain night driving-related visual difficulties. It is recommended to incorporate measurement of these visual functions into assessments related to driving performance.
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Affiliation(s)
- Samuel Bert Boadi-Kusi
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Princess Marie Aikins
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer Zaabaar
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana; Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
| | - Anthony Gyimah Duku
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Yang J, Alshaikh E, Yu D, Kerwin T, Rundus C, Zhang F, Wrabel CG, Perry L, Lu ZL. Visual Function and Driving Performance Under Different Lighting Conditions in Older Drivers: Preliminary Results From an Observational Study. JMIR Form Res 2024; 8:e58465. [PMID: 38922681 PMCID: PMC11237778 DOI: 10.2196/58465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/04/2024] [Accepted: 05/04/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Age-related vision changes significantly contribute to fatal crashes at night among older drivers. However, the effects of lighting conditions on age-related vision changes and associated driving performance remain unclear. OBJECTIVE This pilot study examined the associations between visual function and driving performance assessed by a high-fidelity driving simulator among drivers 60 and older across 3 lighting conditions: daytime (photopic), nighttime (mesopic), and nighttime with glare. METHODS Active drivers aged 60 years or older participated in visual function assessments and simulated driving on a high-fidelity driving simulator. Visual acuity (VA), contrast sensitivity function (CSF), and visual field map (VFM) were measured using quantitative VA, quantitative CSF, and quantitative VFM procedures under photopic and mesopic conditions. VA and CSF were also obtained in the presence of glare in the mesopic condition. Two summary metrics, the area under the log CSF (AULCSF) and volume under the surface of VFM (VUSVFM), quantified CSF and VFM. Driving performance measures (average speed, SD of speed [SDspeed], SD of lane position (SDLP), and reaction time) were assessed under daytime, nighttime, and nighttime with glare conditions. Pearson correlations determined the associations between visual function and driving performance across the 3 lighting conditions. RESULTS Of the 20 drivers included, the average age was 70.3 years; 55% were male. Poor photopic VA was significantly correlated with greater SDspeed (r=0.26; P<.001) and greater SDLP (r=0.31; P<.001). Poor photopic AULCSF was correlated with greater SDLP (r=-0.22; P=.01). Poor mesopic VUSFVM was significantly correlated with slower average speed (r=-0.24; P=.007), larger SDspeed (r=-0.19; P=.04), greater SDLP (r=-0.22; P=.007), and longer reaction times (r=-0.22; P=.04) while driving at night. For functional vision in the mesopic condition with glare, poor VA was significantly correlated with longer reaction times (r=0.21; P=.046) while driving at night with glare; poor AULCSF was significantly correlated with slower speed (r=-0.32; P<.001), greater SDLP (r=-0.26; P=.001) and longer reaction times (r=-0.2; P=.04) while driving at night with glare. No other significant correlations were observed between visual function and driving performance under the same lighting conditions. CONCLUSIONS Visual functions differentially affect driving performance in different lighting conditions among older drivers, with more substantial impacts on driving during nighttime, especially in glare. Additional research with larger sample sizes is needed to confirm these results.
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Affiliation(s)
- Jingzhen Yang
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
- Department of Pediatrics, The Ohio State University, Columbus, OH, United States
| | - Enas Alshaikh
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Deyue Yu
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Thomas Kerwin
- Driving Simulation Laboratory, The Ohio State University, Columbus, OH, United States
| | - Christopher Rundus
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Fangda Zhang
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Cameron G Wrabel
- Driving Simulation Laboratory, The Ohio State University, Columbus, OH, United States
| | - Landon Perry
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Zhong-Lin Lu
- Division of Arts and Sciences, NYU Shanghai, Shanghai, China
- Center for Neural Science and Department of Psychology, New York University, New York, NY, United States
- NYU-ECNU Institute of Brain and Cognitive Science at NYU Shanghai, Shanghai, China
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Terheyden JH, Pondorfer SG, Behning C, Berger M, Carlton J, Rowen D, Bouchet C, Poor S, Luhmann UFO, Leal S, Holz FG, Butt T, Brazier JE, Finger RP. Disease-specific assessment of Vision Impairment in Low Luminance in age-related macular degeneration - a MACUSTAR study report. Br J Ophthalmol 2023; 107:1144-1150. [PMID: 35354561 PMCID: PMC10359508 DOI: 10.1136/bjophthalmol-2021-320848] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/07/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To further validate the Vision Impairment in Low Luminance (VILL) questionnaire, which captures visual functioning and vision-related quality of life (VRQoL) under low luminance, low-contrast conditions relevant to age-related macular degeneration (AMD). METHODS The VILL was translated from German into English (UK), Danish, Dutch, French, Italian and Portuguese. Rasch analysis was used to assess psychometric characteristics of 716 participants (65% female, mean age 72±7 years, 82% intermediate AMD) from the baseline visit of the MACUSTAR study. In a subset of participants (n=301), test-retest reliability (intraclass correlation coefficient (ICC) and coefficient of repeatability (CoR)) and construct validity were assessed. RESULTS Four items were removed from the VILL with 37 items due to misfit. The resulting Vision Impairment in Low Luminance with 33 items (VILL-33) has three subscales with no disordered thresholds and no misfitting items. No differential item functioning and no multidimensionality were observed. Person reliability and person separation index were 0.91 and 3.27 for the Vision Impairment in Low Luminance Reading Subscale (VILL-R), 0.87 and 2.58 for the Vision Impairment in Low Luminance Mobility Subscale (VILL-M), and 0.78 and 1.90 for the Vision Impairment in Low Luminance Emotional Subscale (VILL-E). ICC and CoR were 0.92 and 1.9 for VILL-R, 0.93 and 1.8 for VILL-M and 0.82 and 5.0 for VILL-E. Reported VRQoL decreased with advanced AMD stage (p<0.0001) and was lower in the intermediate AMD group than in the no AMD group (p≤0.0053). CONCLUSION The VILL is a psychometrically sound patient-reported outcome instrument, and the results further support its reliability and validity across all AMD stages. We recommend the shortened version of the questionnaire with three subscales (VILL-33) for future use. TRIAL REGISTRATION NUMBER NCT03349801.
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Affiliation(s)
| | | | - Charlotte Behning
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Moritz Berger
- Department of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - Jill Carlton
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Donna Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | | | - Ulrich F O Luhmann
- Roche Pharmaceutical Research and Early Development, Translational Medicine Ophthalmology, Roche Innovation Center Basel, Basel, Switzerland
| | | | - Frank G Holz
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Thomas Butt
- UCL Institute of Ophthalmology, University College London, London, UK
| | - John E Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert P Finger
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
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Wood JM. Improving the conspicuity and safety of pedestrians and cyclists on night-time roads. Clin Exp Optom 2023; 106:227-237. [PMID: 36774920 DOI: 10.1080/08164622.2023.2174001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
The visual limitations of drivers at night are a key contributing factor to the relatively high crash involvement of vulnerable road users including pedestrians, roadworkers and cyclists on night-time roads. Making vulnerable road users more conspicuous (recognisable, rather than simply visible) to oncoming drivers, is one approach to increasing their safety and has been a particular focus of my research. This review highlights the experimental approaches that our multidisciplinary research team have adopted to explore these issues, involving both closed and open road studies at night. One effective strategy to increase night-time conspicuity of vulnerable road users is clothing that includes retro-reflective materials on the moveable joints which, when illuminated in the headlight beam of oncoming vehicles, creates a strong sense of 'biological motion' or 'biomotion'. Our studies demonstrated that this basic visual perception allows drivers to accurately perceive the presence of a person, such as a pedestrian or cyclist, at much longer distances than when retro-reflective materials are positioned on the torso, as in high visibility vests. Subsequent studies demonstrated that the benefits of biomotion clothing are evident in cluttered environments, in the presence of glare, and for drivers of different ages and visual characteristics. Evidence gathered in these studies was instrumental in changing Australian and New Zealand standards governing high visibility clothing for roadworkers to include retro-reflective strips in the biomotion configuration. Ongoing studies are exploring how to make biomotion clothing attractive to vulnerable road users exercising at night, and how to ensure that the limitations of night-time vision and the importance of increasing night-time conspicuity are better understood. This body of research has involved collaborators from a range of disciplines who have been essential to understanding and addressing the visual challenges of night-time roads and assisted in translating this research into tangible benefits for night-time road safety.
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Affiliation(s)
- Joanne M Wood
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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5
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Jones PR, Ungewiss J, Eichinger P, Wörner M, Crabb DP, Schiefer U. Contrast Sensitivity and Night Driving in Older People: Quantifying the Relationship Between Visual Acuity, Contrast Sensitivity, and Hazard Detection Distance in a Night-Time Driving Simulator. Front Hum Neurosci 2022; 16:914459. [PMID: 35966995 PMCID: PMC9373794 DOI: 10.3389/fnhum.2022.914459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose (i) To assess how well contrast sensitivity (CS) predicts night-time hazard detection distance (a key component of night driving ability), in normally sighted older drivers, relative to a conventional measure of high contrast visual acuity (VA); (ii) To evaluate whether CS can be accurately quantified within a night driving simulator. Materials and Methods Participants were 15 (five female) ophthalmologically healthy adults, aged 55–81 years. CS was measured in a driving simulator using Landolt Cs, presented under static or dynamic driving conditions, and with or without glare. In the dynamic driving conditions, the participant was asked to simultaneously maintain a (virtual) speed of 60 km/h on a country road. In the with glare conditions, two calibrated LED arrays, moved by cable robots, simulated the trajectories and luminance characteristics of the (low beam) headlights of an approaching car. For comparison, CS was also measured clinically (with and without glare) using a Optovist I instrument (Vistec Inc., Olching, Germany). Visual acuity (VA) thresholds were also assessed at high and low contrast using the Freiburg Visual Acuity Test (FrACT) under photopic conditions. As a measure of driving performance, median hazard detection distance (MHDD) was computed, in meters, across three kinds of simulated obstacles of varying contrast. Results Contrast sensitivity and low contrast VA were both significantly associated with driving performance (both P < 0.01), whereas conventional high contrast acuity was not (P = 0.10). There was good correlation (P < 0.01) between CS measured in the driving simulator and a conventional clinical instrument (Optovist I). As expected, CS was shown to decrease in the presence of glare, in dynamic driving conditions, and as a function of age (all P < 0.01). Conclusion Contrast sensitivity and low contrast VA predict night-time hazard detection ability in a manner that conventional high contrast VA does not. Either may therefore provide a useful metric for assessing fitness to drive at night, particularly in older individuals. CS measurements can be made within a driving simulator, and the data are in good agreement with conventional clinical methods (Optovist I).
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Affiliation(s)
- Pete R. Jones
- Department of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
| | - Judith Ungewiss
- Competence Center “Vision Research”, Study Course Ophthalmic Optics and Optometry, University of Applied Sciences, Aalen, Germany
- Carl Zeiss Vision International GmbH, Aalen, Germany
- *Correspondence: Judith Ungewiss,
| | - Peter Eichinger
- Study Course Mechatronics, University of Applied Sciences, Aalen, Germany
| | - Michael Wörner
- Competence Center “Vision Research”, Study Course Ophthalmic Optics and Optometry, University of Applied Sciences, Aalen, Germany
- Blickshift GmbH, Stuttgart, Germany
| | - David P. Crabb
- Department of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
| | - Ulrich Schiefer
- Competence Center “Vision Research”, Study Course Ophthalmic Optics and Optometry, University of Applied Sciences, Aalen, Germany
- Department of Ophthalmology, University of Tübingen, Tübingen, Germany
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Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. What we have learnt from 30 years living with positive dysphotopsia after intraocular lens implantation?: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1917997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - Noemi Burguera
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology (Imqo-oftalmar), Vithas Medimar International Hospital, Alicante, Spain
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Boadi‐Kusi SB, Austin E, Abu SL, Holdbrook S, Morny EKA. Disability glare and nighttime driving performance among commercial drivers in Ghana. J Occup Health 2021; 63:e12279. [PMID: 34529317 PMCID: PMC8444958 DOI: 10.1002/1348-9585.12279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Glare caused by the headlights of on-coming vehicles risk safe driving at night. The study aimed to determine the relationship between glare exposure and nighttime driving performance among commercial drivers in Ghana. METHODS This cross-sectional study involved commercial drivers with complaints of nighttime driving difficulties (N = 80; mean age = 41.5 ± 11.1 years). A questionnaire was used to investigate nighttime driving performance following glare exposure. We measured contrast sensitivity and visual acuity under photopic conditions. With an experimental setup in a mesopic setting, we measured visual acuity with and without glare exposure. The difference between the two mesopic visual acuities was quantified as disability glare index. With the same setup, photostress recovery time was also measured. Regression analyses were used to determine the relationship between nighttime driving performance score and the measures taken in both photopic and mesopic settings. RESULTS The average nighttime driving performance score was 47.8 ± 17.5. Driving performance was negatively correlated with all variables (R = -0.87 to -0.30, all p < .01), except contrast sensitivity (R = 0.74, p < .01). A multiple linear regression showed that the model with all variables explained 83.8% of the variance, but only disability glare index was a significant predictor of nighttime driving performance following glare exposure (standardized B = -0.61, p < .01). CONCLUSION Our results show that the change in mesopic visual acuities following glare can predict nighttime driving performance. This measure can be incorporated into the assessment of driving fitness by licensing departments to evaluate whether a person can drive safely at night amidst glare exposure.
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Affiliation(s)
- Samuel Bert Boadi‐Kusi
- Department of Optometry and Vision ScienceSchool of Allied Health SciencesCollege of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
| | | | - Sampson Listowell Abu
- Department of Ophthalmology and Visual SciencesSchool of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Selina Holdbrook
- Department of Optometry and Vision ScienceSchool of Allied Health SciencesCollege of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
| | - Enyam Komla Amewuho Morny
- Department of Optometry and Vision ScienceSchool of Allied Health SciencesCollege of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
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8
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Active Road Studs as an Alternative to Lighting on Rural Roads: Driver Safety Perception. SUSTAINABILITY 2020. [DOI: 10.3390/su12229648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Drivers, particularly with increasing age, cite driving at night as being problematic and feeling unsafe. Ultimately this may result in self-regulation and avoidance, with potentially negative health effects. The issue is commonly mitigated through provision of street lighting, but with it comes cost, environmental impact, and other negative effects. Research has suggested that provision of LED Active Road Studs may be of assistance to drivers at night. However, it is not known how implementation of this measure affects driver confidence, as research to date has focused on observational study of actual driving behaviour. The present work addresses this gap in knowledge using data from 698 respondents to a questionnaire survey of households around a recently treated route. Overall, 72% reported an increase in confidence driving at night, with key reasons cited as increased preview time and reduced glare. A total of 80% of respondents believed the overall safety of the study route had improved. Underlying confidence was found to be lower in females, with confidence increasing with mileage driven. This study is the first to suggest the use of active road studs may increase driver confidence and provide increased travel opportunities, particularly where street lighting is impractical or undesirable in terms of sustainability.
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McGuinness MB, Fraser RG, Tan R, Luu CD, Guymer RH. Relationship Between Rod-Mediated Sensitivity, Low-Luminance Visual Acuity, and Night Vision Questionnaire in Age-Related Macular Degeneration. Transl Vis Sci Technol 2020; 9:30. [PMID: 32821527 PMCID: PMC7409161 DOI: 10.1167/tvst.9.6.30] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/30/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To quantify the association between dark adaptation parameters and other clinical measures of visual function among people with and without early and intermediate age-related macular degeneration (AMD). Methods In this cross-sectional study, participants underwent multimodal imaging and visual function testing, including best-corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), low-luminance deficit (LLD = BCVA – LLVA) and the 10-item Night Vision Questionnaire (NVQ-10). Dynamic and static dark-adapted chromatic perimetry (DACP) was performed. Sensitivity difference was defined as the difference in sensitivity between the 505-nm and 625-nm stimuli. Rod intercept time (RIT) was estimated as the time required to reach a threshold of −3 log candelas/meter2 with the 505-nm stimulus following bleaching. The magnitude of association between the DACP parameters and other clinical tests was estimated via mixed-effects regression. Results A total of 51 participants (aged 51–88 years, 65% female, 39% with AMD) were included. RIT was found to be negatively associated with BCVA (P < 0.001), LLVA (P = 0.005), and NVQ-10 score (P = 0.028) but not LLD (P = 0.763). There was no evidence of an association between sensitivity difference and any of the clinical measures (P ≥ 0.081). Conclusions Reduced rod function, as determined by RIT, was associated with lower NVQ-10 scores (designed to interrogate rod-mediated function) and with worse BCVA and LLVA (measures of cone function). Translational Relevance Decreasing rod function maybe indicative of more generalized photoreceptor dysfunction involving cones. Further development of questionnaires to target function in scotopic conditions may provide an easier to administer test without the need to perform perimetric tests of rod function.
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Affiliation(s)
- Myra B McGuinness
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Rogan G Fraser
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Rose Tan
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.,Department of Surgery (Ophthalmology), The University of Melbourne, East Melbourne, Victoria, Australia
| | - Chi D Luu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.,Department of Surgery (Ophthalmology), The University of Melbourne, East Melbourne, Victoria, Australia
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.,Department of Surgery (Ophthalmology), The University of Melbourne, East Melbourne, Victoria, Australia
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10
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Kimlin JA, Black AA, Wood JM. Older drivers' self-reported vision-related night-driving difficulties and night-driving performance. Acta Ophthalmol 2020; 98:e513-e519. [PMID: 31773899 DOI: 10.1111/aos.14311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/31/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate associations between older drivers' perceived vision-related night-driving difficulties and night-time driving performance measured on a closed-road circuit. METHODS Participants included 26 older drivers (71.8 ± 6.3 years) who reported vision-related night-driving difficulties assessed with the vision and night driving questionnaire (VND-Q). High-contrast, photopic visual acuity (VA) and ratings of discomfort glare (de Boer scale) were also assessed. Night-time driving performance was measured on a closed-road circuit that involved recognition, hazard avoidance and lane-keeping tasks in the absence and presence of intermittent glare. Generalized linear mixed models investigated the relationship between VND-Q scores and overall driving performance scores, as well as with discomfort glare ratings and VA. RESULTS Greater levels of vision-related night-driving difficulties (VND-Q scores) were significantly associated with poorer night-driving performance (p = 0.003); the association was even stronger for driving performance in the presence of intermittent glare (p = 0.001). Reduced VA was associated with poorer night-driving performance (p = 0.022) but the association was weaker than for the VND-Q scores. In contrast, ratings of discomfort glare were not significantly associated with driving performance (p = 0.14). CONCLUSION The VND-Q was significantly associated with night-time driving performance and provides a useful instrument for assessing vision-related night-driving difficulties which can be incorporated into clinical vision assessments.
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Affiliation(s)
- Janessa A Kimlin
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Alex A Black
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Joanne M Wood
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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11
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Wood JM. Nighttime driving: visual, lighting and visibility challenges. Ophthalmic Physiol Opt 2019; 40:187-201. [DOI: 10.1111/opo.12659] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 10/27/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Joanne M Wood
- School of Optometry and Vision Science and Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
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12
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Wood JM. 2015 Glenn A. Fry Award Lecture: Driving toward a New Vision: Understanding the Role of Vision in Driving. Optom Vis Sci 2019; 96:626-636. [PMID: 31479017 DOI: 10.1097/opx.0000000000001421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
More than 90% of the sensory information that we use for driving is estimated to be visual. However, there is ongoing debate regarding the extent to which different ocular conditions and types of visual impairment affect driving performance and which visual functions are most important for safe driving. My program of research has sought to address these questions using a range of experimental approaches including measures of real-world driving performance on a closed-circuit driving course and under in-traffic conditions. This article provides a current overview of how visual impairment affects driving ability and safety and also highlights the visual challenges of nighttime driving, including the visibility of vulnerable road users, based on the wider research literature, as well as providing a snapshot of some of my own studies. Emphasis is placed on those studies that are relevant to assessing a patient's visual fitness to drive, as well as providing appropriate advice regarding the impact of common visual impairments on driving ability and safety.
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Black AA, Wood JM, Colorado LH, Collins MJ. The impact of uncorrected astigmatism on night driving performance. Ophthalmic Physiol Opt 2019; 39:350-357. [DOI: 10.1111/opo.12634] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/18/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Alex A Black
- School of Optometry and Vision Science and the Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
| | - Joanne M Wood
- School of Optometry and Vision Science and the Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
| | - Luisa H Colorado
- School of Optometry and Vision Science and the Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
| | - Michael J Collins
- School of Optometry and Vision Science and the Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
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Wood JM, Isoardi G, Black A, Cowling I. Night-time driving visibility associated with LED streetlight dimming. ACCIDENT; ANALYSIS AND PREVENTION 2018; 121:295-300. [PMID: 30317014 DOI: 10.1016/j.aap.2018.08.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/04/2018] [Accepted: 08/21/2018] [Indexed: 06/08/2023]
Abstract
New LED streetlighting designs and dimming are being introduced worldwide, however, while their cost savings are well established, their impact on driving performance has received little attention. This study investigated the effect of streetlight dimming on night-time driving performance. Participants included 14 licensed drivers (mean age 34.2 ± 4.9 years, range 27-40 years) who drove an instrumented vehicle around a closed circuit at night. Six LED streetlights were positioned along a 250 m, straight section and their light output varied between laps (dimming levels of 25%, 50%, 75% and 100% of maximum output; L25, L50, L75 and L100 respectively; at 100% average road surface luminance of 1.14 cd/m2). Driving tasks involved recognition distances and reaction times to a low contrast, moving target and a pedestrian walking at the roadside. Participants drove at an average driving speed of 55 km/hr in the streetlight zone. Streetlight dimming significantly delayed driver reaction times to the moving target (F3,13.06 = 6.404; p = 0.007); with an average 0.4 s delay in reaction times under L25 compared to L100, (estimated reduction in recognition distances of 6 m). Pedestrian recognition distances were significantly shorter under dimmed streetlight levels (F3,12.75 = 8.27; p = 0.003); average pedestrian recognition distances were 15 m shorter under L25 compared to L100, and 11 m shorter under L50 compared to L100. These data suggest that streetlight dimming impacts on driver visibility but it is unclear how these differences impact on safety; future studies are required to inform decisions on safe dimming levels for road networks.
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Affiliation(s)
- Joanne M Wood
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
| | | | - Alex Black
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ian Cowling
- School of Chemistry, Physics and Mechanical Engineering, Faculty of Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
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Spreng L, Favrat B, Borruat FX, Vaucher P. Cross-sectional study assessing the addition of contrast sensitivity to visual acuity when testing for fitness to drive. BMJ Open 2018; 8:e018546. [PMID: 29374663 PMCID: PMC5829587 DOI: 10.1136/bmjopen-2017-018546] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The aim of this study is to quantify the importance of loss of contrast sensitivity (CS) and its relationship to loss of visual acuity (VA), driving restrictions and daytime, on-road driving evaluations in drivers aged 70+. DESIGN A predictive cross-sectional study. SETTING Volunteer participants to a drivers' refresher course for adults aged 70+ delivered by the Swiss Automobile Club in western Switzerland from 2011 to 2013. PARTICIPANTS 162 drivers, male and female, aged 70 years or older. CLINICAL PREDICTORS We used a vision screener to estimate VA and the The Mars Letter Contrast Sensitivity Test to test CS. OUTCOMES We asked drivers to report whether they found five driving restrictions useful for their condition; restrict driving to known roads, avoid driving on highways, avoid driving in the dark, avoid driving in dense traffic and avoid driving in fog. All participants also underwent a standardised on-road evaluation carried out by a driving instructor. RESULTS Moderate to severe loss of CS for at least one eye was frequent (21.0% (95% CI 15.0% to 28.1%)) and often isolated from a loss of VA (11/162 cases had a VA ≥0.8 decimal and a CS of ≤1.5 log(CS); 6.8% (95% CI 3.4% to 11.8%)). Drivers were more likely (R2=0.116, P=0.004) to report a belief that self-imposed driving restrictions would be useful if they had reduced CS in at least one eye. Daytime evaluation of driving performance seems limited in its ability to correctly identify difficulties related to CS loss (VA: R2=0.004, P=0.454; CS: R2=0.006, P=0.332). CONCLUSION CS loss is common for older drivers. Screening CS and referring for cataract surgery even in the absence of VA loss could help maintain mobility. Reduced CS and moderate reduction of VA were both poor predictors of daytime on-road driving performances in this research study.
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Affiliation(s)
- Lucie Spreng
- Doctoral School of Medicine, Faculty of Medicine and Biology, University of Lausanne, Lausanne, Switzerland
| | - Bernard Favrat
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
- Unit of Psychology and Traffic Medicine, University Centre of Legal Medicine Lausanne-Geneva, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - François-Xavier Borruat
- Ophthalmology Department, Jules-Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland
| | - Paul Vaucher
- Unit of Psychology and Traffic Medicine, University Centre of Legal Medicine Lausanne-Geneva, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
- aR&D, School of Health Sciences Fribourg, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland
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