Safe Driving Possible Despite Loss of Visual Field
People with a reduced visual field due to glaucoma or stroke who regained their licenses after passing a simulator-based assessment showed similar driving performance on the road as that of their peers with normal vision.
METHODOLOGY:
Researchers in Sweden investigated the driving performance of people with a reduced visual field who regained their licenses after passing a simulator-based assessment and compared it with that of younger and similarly aged individuals with normal vision.
They matched people with a reduced visual field (n = 72; mean age, 66 years) on the basis of sex and familiarity with the environment to control individuals with normal vision of similar (n = 70; mean age, 67 years) and younger (n = 70; mean age, 26 years) ages; the group with reduced visual field failed to meet the standard of an approved visual field defined by Swedish law.
All participants underwent standardized driving tests conducted by certified examiners at 39 traffic offices nationwide who were blinded to their allocation; examiners evaluated participants' knowledge about vehicles, adherence to traffic rules, and traffic safety using the Swedish national driving test protocol.
TAKEAWAY:
The pass rates achieved by the reduced visual field, similarly aged, and younger aged groups were 68%, 66%, and 81%, respectively, with no significant difference between the groups; driving habits, the number of tested checkpoints, and interventions were also comparable across groups.
Among people with a reduced visual field, no difference in pass rate was observed with regard to the type of diagnosis.
Older age was linked to a significantly lower likelihood of passing the test ( P < .05), with younger drivers showing better attentiveness than older drivers, regardless of having a reduced visual field.
IN PRACTICE:
'The results clearly indicate that individuals with VFL [visual field loss] can be safe drivers, performing at least as well as matched, normally sighted controls,' the researchers wrote. 'Simulator and on-road tests are critical tools for individualized assessment, challenging the sole reliance on perimetry for licensing decisions. These findings support the inclusion of practical on-road driving tests as a regulatory option for individuals with VFL, promoting mobility while maintaining road safety.'
SOURCE:
This study was conducted by Tomas Bro of the Department of Biomedical and Clinical Sciences at Linköping University, Linköping, Sweden. It was published online on May 9, 2025, in Acta Ophthalmologica .
LIMITATIONS:
Data on loss of visual field were collected at the time of application for the simulator test, leading to inconsistencies in the availability and recency of these perimetric results, with some findings being at least 4 years old.
DISCLOSURES:
The study was supported by grants from Stiftelsen Promobilia. No other disclosures were reported by the authors.
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