VISION AND DRIVING

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VISION AND DRIVING

• Neryla Jolly
• Orthoptist, Senior Lecturer
• Faculty of Health Sciences

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Driver Team Orthoptist, OT, Driving Instructor

• Experience
• Drivers with disability visual and physical
• Off and on-road assessment
• Remediation
• Research
• OHS assessments
• Consultancies
• Community senior sessions

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Aim of talk

• Expertise in vision and driving to include
• Understanding of eye conditions
• Vision tests
• Impact on driving skill / living
• Practical tips

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Requirements for driving

• Knowledge of the rules of the road
• Skills to handle a vehicle
• Good vision -3 criteria
• The right attitude
• The ability to manage all this in a moving
  rapidly changing environment

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Vision requirement ONE

• Acuity of 6/12 (no 5)
• Num 8 6/6 is normal
• Num 9 6/5 is frequent

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• Why might vision be
• less than this level?
• Need glasses
• Cataracts
• Macular problems
• Eye diseases
• Can the acuity be improved?

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Acuity defects what happens in driving?

• Vehicle control- very good / expert
• Sign identification
• Road position
• Speed
• Scan
• Mirror use
• Hazard identification

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Acuity defects what happens in driving?

• Sign identification- 1 line decrease worse than
  6/12 sign identification 1 car length away, 2
  lines decrease worse signs often missed
• Road position all decreased vision levels
  variable to right and left, often over the middle
  line, 2 lines decrease and worse near
  collisions (use passenger)

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Acuity defects what happens in driving?

• 3. Speed slow
• 4. Scan often fixed, trained but non effective

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Acuity defects what happens in driving?

• 5. Mirror use routine
• 6. Hazard identification all decreased vision
  levels, missed trucks pedestrians

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Vision requirement TWO

• No double vision in the central area

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• Why might double vision appear?
• 1. Head injury 2. Neurological conditions
• 3 Medical conditions (diabetes, )
• Can the double vision be improved?

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Double vision what happens in driving?

• Shock (woman / stroller)
• Confusion about signs / road markings
• Scanning avoided
• Missing hazards cars on roundabouts,
  pedestrians
• Distance judgment problems
• Extensive head postures

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Vision requirement THREE

• Peripheral vision 120 degrees

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Binocular peripheral vision numeric field
results static
kinetic
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• What might cause peripheral vision to decrease?
• Glaucoma
• Neurological conditions
• Retinal problems
• Can the peripheral vision be improved?

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• What effect does peripheral vision loss have on
  driving?
• Reduced field poor driving performance
• Make errors of identification of objects opposite
  side of loss
• Position judgment poor in confined spaces
• Some drivers compensate by scanning

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Changing age and driving

• What we do know
• Visual sensitivity decreases (response to glare
  and in reduced light stereopsis)
• After the age of 70 years the accident rate
  increases
• Driving is extremely important for independence,
  safety and life enjoyment
• Experience is important in driving

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Contrast sensitivity (light dark) visual
sensitivity age.
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Senior Drivers Study

• 100 drivers aged 60 to 85 years
• 65 males, 35 females
• drive between 1 to 6 hours a day (41 1hour, 23
  2 hours) 95 stated they were comfortable when
  driving.
• 86 drive between 1 6 nights a week (26 1
  night 34 2 nights a week) 74 are comfortable
  driving at night

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Vision responses

• Visual acuity both eyes- 6/5 mean (9)
• (range 6/60 (1) to 6/3 (11) )
• Peripheral vision 49 with no errors 24 with
  lt 7 errors 9 with gt20 errors
• Double vision- 2
• Stereopsis
• 25 full response
• 15 no response

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Senior Drivers Study- results from 33 question
pairs

• Driving into setting sun (Light related
  situation)
• Road markings wet road, night (Light related
  situation)
• High pedestrian area
• Right turn without lights (Vehicle Direction
  change)
• Left lane change (Vehicle Direction change)
• Dark with dim street lights (Light related
  situation)
• Right turn at roundabout (Vehicle Direction
  change)
• Traffic lights at dusk (Light related situation)
• high accident

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Senior Drivers Study, Results Vision Behaviours
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Senior Drivers, results - commentary

• GENERAL AREA ITEM (n 14) PERFORMED
• SIGN Lidcombe 57
• Children 41
• School zone 70
• Zigzag crossing on road 22
• Pedestrian crossing 42 32
• Hump 47 twice
• SPEED 40 kmh 80
• 25kmh 82 77
• 50 kmh 79, 62 57
• PEDESTRIAN CROSSING 28 22

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Senior Drivers what have we learnt

• Senior Drivers identify problems in light related
  situations, vehicle direction change and high
  pedestrian numbers require more care
• 2. Speed signs and school signs cause more
  conscious reporting
• 3. Some skills could be improved to increase safe
  driving potential
• Blind spot checks
• Dash board checks
• Rear view mirror checks

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ENVIRONMENT SUPPORT

• Road signs clearly positioned
• Road signs clean
• Road markings clear (changed markings removed)
• Shoulder of road smooth junction surface
• Clearly defined gutters

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• For more information
• Neryla Jolly
• Driver Vision Specialist
• The University of Sydney
• N.Jolly_at_usyd.edu.au