Compensatory Strategies Used by Individuals With Glaucoma to Increase Driving Safety

PURPOSE: The purpose of this preliminary report is to compare driving conditions that were avoided and compensatory strategies used by individuals with glaucoma who drove safely and those who failed the Modified Washington University Road Test (mWURT) (Bhorade et al, 2016). DESIGN: This is a single center, cross-sectional study. One-hundred eighty participants (125 glaucoma and 55 controls) are being recruited from university eye clinics and local private practices. Study participants, age >55, are included if they have 1) a current valid driver's license, 2) visual acuity of 20/70 or better in their better-seeing eye, 3) self-reported driving > once a week in the past 4 weeks and 4) >10 years of driving experience. A glaucoma diagnosis is based on glaucomatous optic nerve cupping and reproducible visual field defects obtained within 6 months. Each eye is separately classified into a glaucoma stage (0-5) using the Glaucoma Staging System (Mills et al, 2006). METHODS: Participants completed a comprehensive evaluation including a battery of questionnaires, vision tests (near and distance acuity, visual field, contrast sensitivity), and an on-road driving assessment (mWURT). The questionnaires include the Driving Strategies Questionnaire which is a 35 item, 3 part self-report measure that assesses changes that study participants have made in their driving to increase safety. Using a 5-point Likert scale, participants rate the frequency of use of strategies related to how and when they drive and conditions they avoid. In addition, participants indicate use of technology and sensors built into their car. Data were analyzed using descriptive statistics, independent sample t tests and the chi square test. RESULTS: This preliminary sample includes 102 older adults with mild to severe glaucoma. The mean age was 69.7 years (+/- 7.5), 52% were female and the majority were white (69.3%). In this preliminary sample, 73% passed the on-road assessment and 27% failed. Compared to those that passed the on-road assessment, those who failed the on-road driving test more frequently avoided 4 of 16 potential driving hazards: driving in high traffic (p