Association between glaucoma and at–fault motor vehicle collision involvement among older drivers

Kwon, MiYoung, Huisingh, Carrie, Rhodes, Lindsay A., McGwin, Gerald, Wood, Joanne M., & Owsley, Cynthia (2016) Association between glaucoma and at–fault motor vehicle collision involvement among older drivers. Ophthalmology, 123(1), pp. 109-116.

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To examine the association between glaucoma and motor vehicle collision (MVC) involvement among older drivers, including the role of visual field impairment that may underlie any association found.


A retrospective population-based study


A sample of 2,000 licensed drivers aged 70 years and older who reside in north central Alabama.


At-fault MVC involvement for five years prior to enrollment was obtained from state records. Three aspects of visual function were measured: habitual binocular distance visual acuity, binocular contrast sensitivity and the binocular driving visual field constructed from combining the monocular visual fields of each eye. Poisson regression was used to calculate crude and adjusted rate ratios (RR) and 95% confidence intervals (CI).

Main Outcomes Measures

At-fault MVC involvement for five years prior to enrollment.


Drivers with glaucoma (n = 206) had a 1.65 (95% confidence interval [CI] 1.20-2.28, p = 0.002) times higher MVC rate compared to those without glaucoma after adjusting for age, gender and mental status. Among those with glaucoma, drivers with severe visual field loss had higher MVC rates (RR = 2.11, 95% CI 1.09-4.09, p = 0.027), whereas no significant association was found among those with impaired visual acuity and contrast sensitivity. When the visual field was sub-divided into six regions (upper, lower, left, and right visual fields; horizontal and vertical meridians), we found that impairment in the left, upper or lower visual field was associated with higher MVC rates, and an impaired left visual field showed the highest RR (RR = 3.16, p = 0.001) compared to other regions. However, no significant association was found in deficits in the right side or along the horizontal or vertical meridian.


A population-based study suggests that older drivers with glaucoma are more likely to have a history of at-fault MVC involvement than those without glaucoma. Impairment in the driving visual field in drivers with glaucoma appears to have an independent association with at-fault MVC involvement, whereas visual acuity and contrast sensitivity impairments do not.

Impact and interest:

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ID Code: 89498
Item Type: Journal Article
Refereed: Yes
DOI: 10.1016/j.ophtha.2015.08.043
ISSN: 0161-6420
Divisions: Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2015 the American Academy of Ophthalmology
Copyright Statement: Licensed under the Creative Commons Attribution; Non-Commercial; No-Derivatives 4.0 International. DOI: 10.1016/j.ophtha.2015.08.043
Deposited On: 27 Oct 2015 00:53
Last Modified: 17 Mar 2016 15:23

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