RESUMEN
@#An age-related ocular disease such as cataract that causes reduction of visual functions would affect the individual driving performance. The aim of this study was to compare driving difficulties between Malaysian drivers with bilateral cataracts and without cataract. This cross-sectional study involved measurement of visual functions [visual acuity (VA) and contrast sensitivity (CS)] and driving difficulty of 61 subjects who are actively driving with valid driving license. Subjects were divided into bilateral cataract group (n=30) and non-cataracts group as control group (n=31); which age and gender matched. Results showed that the mean±SD for composite driving difficulty score in the bilateral cataract group and in the control group were 72.08±15.95 and 87.50±12.60 respectively. It showed that both groups had lower mean composite score which indicates difficulty in driving. Results also showed significant mean difference composite driving difficulty score between cataract and control group (p<0.001). Drivers with bilateral cataracts were also found to have significant difficulty when driving the rain (p=0.034), at night (p=0.013) and when driving on local or highway (p=0.005) compared to drivers without cataract. Subsequent Spearman’s Rho showed significant moderate positive correlation between driving difficulty and binocular CS (rs =0.404, p=0.027). This study showed that drivers with cataract would experience driving difficulties compared to the drivers without cataract.
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The subjective categories that drivers use to distinguish between different road types have been shown to influence the speeds they choose to drive but as yet we do not understand the road features that drivers use to make their discriminations. To better understand how drivers describe and categorise the roads they drive, 55 participants were recruited to drive a video of familiar urban roads in a driving simulator at the speed they would drive these roads in their own cars (using the accelerator and brake pedal in the driving simulator to adjust their speed). The participants were then asked to sort photos of the roads they had just driven into piles so that their driving would be the same on all roads in one pile but different to the other piles. Finally, they answered a series of questions about each road to indicate what speed they would drive, the safe speed for the road, their speed limit belief as well as providing ratings of comfort, difficulty and familiarity. Overall, drivers' categorisation of roads was informed by a number of factors including speed limit belief, road features and markings (including medians), road width, and presence of houses, driveways and footpaths. The participants' categories were congruent with what they thought the speed limits were, but not necessarily the actual speed limits. Mismatches between actual speed limits and speed limit beliefs appeared to result from category-level expectations about speed limits that took precedence over recent experience in the simulator. Roads that historically had a 50km/h speed limit but had been reduced to 40km/h were still regarded as 50km/h roads by the participants, underscoring the point that simply posting a sign with a lower speed limit is not enough to overcome drivers' expectations and habits associated with the visual appearance of a road. The findings provided insights into how drivers view and categorise roads, and identify specific areas that could be used to improve speed limit credibility.
Asunto(s)
Conducción de Automóvil/psicología , Conducción de Automóvil/estadística & datos numéricos , Toma de Decisiones , Adulto , Simulación por Computador , Planificación Ambiental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Población Urbana , Adulto JovenRESUMEN
OBJECTIVE: To investigate self-reported driving difficulty before and after first eye cataract surgery and determine which visual measures are associated with changes in self-reported driving difficulty after surgery. METHODS: A cohort of 99 older drivers with bilateral cataract were assessed the week before and 12 weeks after first eye cataract surgery. Visual measures including visual acuity, contrast sensitivity, stereopsis and useful field of view were assessed. Self-reported driving difficulty was measured via the Driving Habits Questionnaire. Cognitive status was assessed using the Mini Mental State Examination. Regression analysis was undertaken to determine the association between changes in visual measures and self-reported driving difficulty after first eye cataract surgery. RESULTS: Overall, self-reported driving difficulty improved after first eye cataract surgery. However, 16% of participants did not improve and driving difficulty worsened in 11% following surgery. Improvement in driving difficulty score after first eye cataract surgery was associated with improved contrast sensitivity in the operated eye (p<0.001), new glasses after surgery (p<0.001), and fewer chronic health conditions (p=0.016). CONCLUSION: Contrast sensitivity rather than visual acuity was a significant factor affecting change in self-reported driving difficulty after first eye cataract surgery for bilateral patients. This has implications for driver licensing authorities worldwide that rely heavily on visual acuity as a measure of visual fitness to drive.