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On-road driving performance by persons with hemianopia and quadrantanopia

Wood, Joanne M., McGwin, Gerald Jr. , Elgin, Jennifer , Vaphiades, Michael S. , Braswell, Ronald A. , DeCarlo, Dawn K. , Kline, Lanning B. , Meek, G. Christine , Searcey, Karen , & Owsley, Cynthia (2009) On-road driving performance by persons with hemianopia and quadrantanopia. Investigative Ophthalmology & Visual Science, 50(2), pp. 577-585.

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Abstract

PURPOSE: This study was designed to examine the on-road driving performance of drivers with hemianopia and quadrantanopia compared with age-matched controls. METHODS. Participants included persons with hemianopia or quadrantanopia and those with normal visual fields. Visual and cognitive function tests were administered, including confirmation of hemianopia and quadrantanopia through visual field testing. Driving performance was assessed using a dual-brake vehicle and monitored by a certified driving rehabilitation specialist. The route was 14.1 miles of city and interstate driving. Two “back-seat” evaluators masked to drivers’ clinical characteristics independently assessed driving performance using a standard scoring system.--- RESULTS: Participants were 22 persons with hemianopia and 8 with quadrantanopia (mean age, 53 20 years) and 30 participants with normal fields (mean age, 52 19 years). Inter-rater agreement for back-seat evaluators was 96%. All drivers with normal fields were rated as safe to drive, while 73% (16/22) of hemianopic and 88% (7/8) of quadrantanopic drivers received safe ratings. Drivers with hemianopia or quadrantanopia who displayed on-road performance problems tended to have difficulty with lane position, steering steadiness, and gap judgment compared to controls. Clinical characteristics associated with unsafe driving were slowed visual processing speed, reduced contrast sensitivity and visual field sensitivity.--- CONCLUSIONS: Some drivers with hemianopia or quadrantanopia are fit to drive compared with age-matched control drivers. Results call into question the fairness of governmental policies that categorically deny licensure to persons with hemianopia or quadrantanopia without the opportunity for on-road evaluation.

Impact and interest:

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26 citations in Web of Science®

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ID Code: 19039
Item Type: Journal Article
Additional Information: Supported by National Institutes of Health Grants R21-EY14071 and P30-AG22838, EyeSight Foundation of Alabama, Research to Prevent Blindness Inc., the Alfreda J. Schueler Trust, and a QUT Professional Development Leave grant. Submitted for publication June 29, 2008; revised August 17, and September 8 and 24, 2008; accepted December 16, 2008. Disclosure: J.M. Wood, None; G. McGwin, Jr, None; J. Elgin, None; M.S. Vaphiades, None; R.A. Braswell, None; D.K. DeCarlo, None; L.B. Kline, None; G.C. Meek, None; K. Searcey, None; C. Owsley, None The publication costs of this article were defrayed in part by page charge payment. This article must therefore be marked “advertisement” in accordance with 18 U.S.C. §1734 solely to indicate this fact. Corresponding author: Joanne M. Wood, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Queensland, Australia Q4059; j.wood@qut.edu.au. Investigative Ophthalmology & Visual Science, February 2009, Vol. 50, No. 2 Copyright © Association for Research in Vision and Ophthalmology
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Keywords: Visual field, Hemianopia, Quadrantanopia, Driving performance
DOI: 10.1167/iovs.08-2506
ISSN: 0146-0404
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300) > Optometry and Ophthalmology not elsewhere classified (111399)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Optometry & Vision Science
Deposited On: 20 Apr 2009 08:43
Last Modified: 01 Mar 2012 11:06

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