Research on hazard perception testing (HPT) among older drivers with eye disease can be improved with training.

Research on road driving testing with participants with ocular diseases, compared to aged-matched controls, has shown a significant time delay on a useful hazard perception test (HPT).  Importantly, training for improving on the test can be learned for such relevant cohorts reducing the number of crash involvements.  In the journal, Translational Vision Science & Technology (Vol. 10, Iss. 1, 2021), ophthalmic researchers have concluded that, “HPT tests can provide insight into difficulties regarding road hazard detection of older drivers with eye disease and provide a potential avenue for interventions to improve road safety”.

The research study recruited 217 participants aged over 65yrs and older, 99 participants with a range of eye diseases (age-related macular degeneration, glaucoma and cataract) and 118 control participants. Visual acuity, contrast sensitivity and visual fields were assessed using standard clinical measures and other non-clinical measures (useful field of view, motion sensitivity). According to their report, all participants completed a computer-based hazard perception test (HPT), related to driving performance and crash risk.  Following the analysis of the results, participants with eye disease exhibited a 0.73-second delay in the HPT response times, compared to controls (6.61 ± 1.62 seconds vs. 5.88 ± 1.38 seconds; age-adjusted p = 0.012). Comparing with certain eye diseases, subjects with glaucoma exhibited significantly delayed responses compared to those with age-related macular degeneration (p = 0.038) and controls (p = 0.004). In addition, poorer motion sensitivity (standardized β = 0.27; p < 0.001), visual acuity (β = 0.21; p = 0.002), and better-eye mean defect (β = –0.17; p = 0.009) were most strongly associated with delayed HPT responses. Motion sensitivity remained significantly associated with HPT responses, adjusted for visual acuity and visual fields.  In essence, the researchers concluded that, “HPT responses of older drivers with eye disease were delayed compared to controls and translate to an estimated 16-meter longer stopping distance when traveling at 80 km/hr. Decreased motion sensitivity was most strongly associated with delayed HPT responses”.

Slower HPT responses have been shown to be associated with increased crash risk and poorer driving performance in both young and older drivers however, performance of HPT can be improved with training.  In addition to the study, it was demonstrated that a novel training programme with several types of exercise, road awareness and anticipation strategies could improve response times in general by 0.81 secs compared to baseline and this can make a difference.  All patients should be made aware for advice on what minor adjustments that could be supported by patient organisations, clinicians and also insurers to make a safer environment for eye disease community.