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Projected increase in drivers with glaucoma strengthens need for assessment of visual field
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The projected increase in American drivers older than age 65 years and the concordant increase in drivers with glaucoma prompted one presenter to outline the various options for testing visual field in glaucoma patients.
Odette V. Callender, MD, told colleagues at Retina 2011 that approximately 25% of drivers will be older than 65 years by 2024 and that the number of Americans with glaucoma is projected to reach 3.4 million in 2020.
"Glaucoma in and of itself has been found to be a significant and independent risk factor for being in a crash where an injury occurred," she said.
While there is no standard for classifying mild, moderate or severe visual defect in glaucoma patients, the disease primarily affects peripheral vision. Those with mild to moderate glaucoma have 110° to 120° of visual field, a factor that is associated with an increased risk for accidents, Dr. Callender said.
"If patients have even just a mild to moderate restricted horizontal or vertical peripheral field defect, they have problems with certain driving situations," she said.
Driving capabilities that are affected include anticipatory skills, speed matching when changing lanes, crossing lane boundaries, maintaining position when driving around curves and interaction with other drivers on the interstate.
Of the various methods for assessing visual field, Dr. Callender said she uses the Esterman test because it is more readily available than the Humphrey visual field test, assesses binocular vision and can be used to determine the horizontal extent of peripheral vision and search for scotomas.
Dr. Callender cautioned that a significant percentage of higher-risk drivers do not restrict their driving, and even those who do often cause accidents.
- Disclosure: Dr. Callender has no relevant financial interests to disclose.
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