Patients with glaucoma at higher risk for motor vehicle accidents

Older drivers with glaucoma are involved in automobile accidents at a higher rate than their similarly aged counterparts without glaucoma, according to a study.

The prospective 4-year analysis, conducted at Wills Eye Hospital in Philadelphia and presented as a poster at the Association for Research in Vision and Ophthalmology meeting in Vancouver, British Columbia, looked at the relationship between moderate glaucoma and motor vehicle accidents.

Of 142 patients with moderate glaucoma who reported driving, almost 11% reported involvement in at least one motor vehicle accident over the course of the study. Mean age of participants was 64 years. In contrast, only 1.1% of drivers aged 61 years or older reported involvement in a motor vehicle accident in the 2017 Pennsylvania Crash Facts and Statistics report.

At the onset of the study, worse visual field loss was associated with a greater likelihood of reporting involvement in an accident, as were worse contrast sensitivity and poorer vision in both eyes, Sheryl S. Wizov, COA, co-author of the study, told Ocular Surgery News.

“Our study found 7 to 10 participants each year reported they gave up driving due to vision over the 4 years, with a total of 25% of patients over the course of the study turning in their car keys,” Wizov said.

Increasing MVA rates

The researchers assessed visual acuity, visual field and contrast sensitivity. Compressed Assessment of Ability Related to Vision was used to track performance-based visual function, and the National Eye Institute Visual Function Questionnaire measured vision-related quality of life.

In their final multivariable model, worse mean deviation (visual field loss) in a glaucoma patient’s worse eye was significantly associated with greater odds of an auto accident (P < .001).

The rate of motor vehicle accidents increased between visits one through four, from 5.8% to 10.8%. The rate decreased to 5.9% at visit five, but the reason for the decrease is unknown, Wizov said.

“It should be noted that our attrition rate from year to year increased between 5% and 10.3% over the study visits, meaning these people chose, for whatever reason, not to complete all study visits. Overall, from baseline to visit five, the attrition rate was 24%. Analysis continues to try to explain this big shift in self-reported [motor vehicle accidents]. However, given that the difference is between 5% and 10% in about seven patients, it may just be random fluctuation year to year,” she said.

Public health and safety

Reports such as this may bring about changes regarding driving safety.

“Identifying who is more likely to report a [motor vehicle accident] may bring us closer to more serious conversations regarding auto safety and licensing renewal not just for moderate glaucoma patients but for other issues that may affect driving safety, such as concentration, reaction time, and other vision and health issues,” Wizov said. – by Robert Linnehan

Reference:

Wizov SS, et al. Risk of auto accidents in patients with moderate-stage glaucoma. Presented at: Association for Research in Vision and Ophthalmology; April 28-May 2, 2019; Vancouver, British Columbia.

For more information:

Sheryl S. Wizov , COA, can be reached at Glaucoma Research Center, Wills Eye Hospital, 840 Walnut St., Philadelphia, PA 19107; email: swizov@willseye.org.

Disclosure: Wizov reports no relevant financial disclosures.