Obstacle Avoidance, Visual Detection Performance, and Eye-Scanning Behavior of Glaucoma Patients in a Driving Simulator: A Preliminary Study

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Abstract

The objective of this study was to evaluate differences in driving performance, visual detection performance, and eye-scanning behavior between glaucoma patients and control participants without glaucoma. Glaucoma patients (n = 23) and control participants (n = 12) completed four 5-min driving sessions in a simulator. The participants were instructed to maintain the car in the right lane of a two-lane highway while their speed was automatically maintained at 100 km/h. Additional tasks per session were: Session 1: none, Session 2: verbalization of projected letters, Session 3: avoidance of static obstacles, and Session 4: combined letter verbalization and avoidance of static obstacles. Eye-scanning behavior was recorded with an eye-tracker. Results showed no statistically significant differences between patients and control participants for lane keeping, obstacle avoidance, and eye-scanning behavior. Steering activity, number of missed letters, and letter reaction time were significantly higher for glaucoma patients than for control participants. In conclusion, glaucoma patients were able to avoid objects and maintain a nominal lane keeping performance, but applied more steering input than control participants, and were more likely than control participants to miss peripherally projected stimuli. The eye-tracking results suggest that glaucoma patients did not use extra visual search to compensate for their visual field loss. Limitations of the study, such as small sample size, are discussed.

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Global data on visual impairment in the year 2002.

Serge Resnikoff, Donatella Pascolini, Daniel Etya'ale … (2004)

This paper presents estimates of the prevalence of visual impairment and its causes in 2002, based on the best available evidence derived from recent studies. Estimates were determined from data on low vision and blindness as defined in the International statistical classification of diseases, injuries and causes of death, 10th revision. The number of people with visual impairment worldwide in 2002 was in excess of 161 million, of whom about 37 million were blind. The burden of visual impairment is not distributed uniformly throughout the world: the least developed regions carry the largest share. Visual impairment is also unequally distributed across age groups, being largely confined to adults 50 years of age and older. A distribution imbalance is also found with regard to gender throughout the world: females have a significantly higher risk of having visual impairment than males. Notwithstanding the progress in surgical intervention that has been made in many countries over the last few decades, cataract remains the leading cause of visual impairment in all regions of the world, except in the most developed countries. Other major causes of visual impairment are, in order of importance, glaucoma, age-related macular degeneration, diabetic retinopathy and trachoma.

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Errors and violations on the roads: a real distinction?

J. Reason, A Manstead, S Stradling … (1990)

In considering the human contribution to accidents, it seems necessary to make a distinction between errors and violations; two forms of aberration which may have different psychological origins and demand different modes of remediation. The present study investigated whether this distinction was justified for self-reported driver behaviour. Five hundred and twenty drivers completed a driver behaviour questionnaire (DBQ) which asked them to judge the frequency with which they committed various types of errors and violations when driving. Three fairly robust factors were identified: violations, dangerous errors, and relatively harmless lapses, respectively. Violations declined with age, errors did not. Men of all ages reported more violations than women. Women, however, were significantly more prone to harmless lapses (or more honest) than men. These findings were consistent with the view that errors and violations are indeed mediated by different psychological mechanisms. Violations require explanation in terms of social and motivational factors, whereas errors (slips, lapses, and mistakes) may be accounted for by reference to the information-processing characteristics of the individual.

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Risk of falls and motor vehicle collisions in glaucoma.

Aaron LeBlanc, Sharon Haymes, Devkunj Chauhan … (2007)

To investigate the risk of falls and motor vehicle collisions (MVCs) in patients with glaucoma. The sample comprised 48 patients with glaucoma (mean visual field mean deviation [MD] in the better eye = -3.9 dB; 5.1 dB SD) and 47 age-matched normal control subjects, who were recruited from a university-based hospital eye care clinic and are enrolled in an ongoing prospective study of risk factors for falls, risk factors for MVCs, and on-road driving performance in glaucoma. Main outcome measures at baseline were previous self-reported falls and MVCs, and police-reported MVCs. Demographic and medical data were obtained. In addition, functional independence in daily living, physical activity level and balance were assessed. Clinical vision measures included visual acuity, contrast sensitivity, standard automated perimetry, useful field of view (UFOV), and stereopsis. Analyses of falls and MVCs were adjusted to account for the possible confounding effects of demographic characteristics, medications, and visual field impairment. MVC analyses were also adjusted for kilometers driven per week. There were no significant differences between patients with glaucoma and control subjects with respect to number of systemic medical conditions, body mass index, functional independence, and physical activity level (P > 0.10). At baseline, 40 (83%) patients with glaucoma and 44 (94%) control subjects were driving. Compared with control subjects, patients with glaucoma were over three times more likely to have fallen in the previous year (odds ratio [OR](adjusted) = 3.71; 95% CI, 1.14-12.05), over six times more likely to have been involved in one or more MVCs in the previous 5 years (OR(adjusted) = 6.62; 95% CI, 1.40-31.23), and more likely to have been at fault (OR(adjusted) = 12.44; 95% CI, 1.08-143.99). The strongest risk factor for MVCs in patients with glaucoma was impaired UFOV selective attention (OR(adjusted) = 10.29; 95% CI, 1.10-96.62; for selective attention >350 ms compared with

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Author and article information

Contributors

Sanjoy Bhattacharya: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Electronic): 1932-6203

Publication date Collection: 2013

Publication date (Electronic): 16 October 2013

Volume: 8

Issue: 10

Electronic Location Identifier: e77294

Affiliations

[1 ]Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands

[2 ]Rotterdam Ophthalmic Institute (ROI), Rotterdam, The Netherlands

[3 ]Rotterdam Eye Hospital (REH), Rotterdam, The Netherlands

Bascom Palmer Eye Institute, University of Miami School of Medicine;, United States of America

Author notes

* E-mail: j.c.f.dewinter@ 123456tudelft.nl

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: RPV PL ERV HL JW. Performed the experiments: RPV PL ERV JW. Analyzed the data: RPV PL HL JW. Contributed reagents/materials/analysis tools: RPV PL ERV HL JW. Wrote the manuscript: RPV PL ERV HL JW.

Article

Publisher ID: PONE-D-13-23097

DOI: 10.1371/journal.pone.0077294

PMC ID: 3797776

PubMed ID: 24146975

SO-VID: c4f8b0d4-0f13-416e-9fcd-1537ed4e76d7

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 4 June 2013

Date accepted : 1 September 2013

Funding

The research of Joost de Winter was supported by the Dutch Technology Foundation (Stichting voor de Technische Wetenschappen), the Applied Science Division of the Netherlands Organisation for Scientiﬁc Research (Nederlandse Organisatie voor Wetenschappelijk Onderzoek), and the Technology Program of the Ministry of Economic Affairs. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Obstacle Avoidance, Visual Detection Performance, and Eye-Scanning Behavior of Glaucoma Patients in a Driving Simulator: A Preliminary Study

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PLOS Climate

Most cited references 28

Global data on visual impairment in the year 2002.

Errors and violations on the roads: a real distinction?

Risk of falls and motor vehicle collisions in glaucoma.

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