Vision Problems May Cause
Elderly to Restrict Driving

A range of vision problems, from trouble with depth perception to difficulty seeing through glare, may prompt older adults to limit their own driving, according to a new study.

Researchers found that among 629 older drivers, scores on any of several vision tests were poorer among those who had put restrictions on their driving. This, they say, suggests that many older people with vision problems recognize their limitations and adjust their driving habits.

The study included tests that, unlike the standard acuity test where a person reads black letters on a white chart, assess vision in conditions that better simulate those of the road, study author Dr. Lori A. Lott told Reuters Health.

For instance, one test measured "acuity in glare," which gives an idea of how well a driver can see when the sun is low in the sky or when confronted with oncoming headlights. Lott's team found that poorer performance on this test was associated with higher odds that a driver had limited his or her driving.

She and her colleagues at the Smith Kettlewell Eye Research Institute in San Francisco report the findings in the Journal of the American Geriatrics Society.

According to Lott, past research has shown that when it comes to eye tests that reflect vision under various driving conditions, elderly adults may do much worse than younger drivers.

"So the main goal of this study was to find out whether older individuals with poor vision under these conditions appropriately restrict their driving," she explained.

Among the 629 study participants, the majority had set limits on their driving, with 200 doing so because of vision problems. The authors found that worse performance on a number of tests, such as measures of depth perception and visual acuity under poor lighting, was associated with a greater likelihood of driving restriction.

But poor test performance did not always predict whether a study participant had curbed his driving. This was true of a test that measured "attentional visual field," a driver's ability to focus on what's straight ahead but still see and react to happenings in the periphery.

The fact that drivers who scored poorly on this test were not more likely to limit their driving is surprising, and concerning, according to Lott. She noted that research using a similar test has shown that people who score poorly are more likely to have accidents.

Most of the vision tests Lott and her colleagues used are not part of standard eye exams, but the researchers believe they should be--particularly for elderly patients.

"These tests," Lott said, "would allow an eye doctor to make recommendations about the types of driving situations the elderly patient might want to avoid."

SOURCE: Journal of the American Geriatrics Society, October 2003.

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