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    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
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      <title>Self-reported driving difficulty, avoidance, and negative emotion with on-road driving performance in older adults with glaucoma</title>
      <link>https://trid.trb.org/View/2023852</link>
      <description><![CDATA[To investigate the relationship between self-perceived driving difficulty, driving avoidance, and negative emotion about driving with glaucoma severity and on-road driving performance. Glaucoma patients (n = 111), aged 55 to 90 years, with mild, moderate, and advanced glaucoma in the better-eye based on the Glaucoma Staging System, and age-matched controls (n = 47) were recruited from a large tertiary academic center. Self-reported questionnaires were administered by a trained occupational therapist followed by a standardized on-road driving evaluation (pass vs "at-risk" score) with a masked and certified driving rehabilitation specialist. Compared to controls, glaucoma participants reported greater driving difficulty with as early as mild glaucoma (P = .0391) and negative emotion about driving starting with moderate glaucoma (P = .0042). Glaucoma participants reporting at least 1 driving difficulty and negative emotion had a 3.3-fold (adjusted odds ratio [OR] = 3.3; 95% CI = 1.24-8.52; P = .0163) and 4.2-fold (adjusted OR = 4.2; 95% CI = 1.5-12.2; P = .0078) greater odds, respectively, of an at-risk score on the on-road test. Self-reported driving difficulty in "difficult" conditions (P = .0019), rain (P = .0096), interstates (P = .0378), and high traffic (P = .0076), driving avoidance on sunny (P = .0065) and cloudy (P = .0043) days, and driving fewer days per week (P = .0329) were also associated with at-risk driving. Screening tools that assess self-perceived driving difficulty and driving avoidance in specific conditions, negative emotion about driving, and driving exposure may help identify unsafe drivers with glaucoma. Some of these drivers, particularly those with modest glaucoma, may benefit from a driving evaluation and early referral to resources that could enable them to continue driving safely and confidently.]]></description>
      <pubDate>Tue, 27 Sep 2022 09:19:42 GMT</pubDate>
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      <title>On-road Driving Performance of Patients With Bilateral Moderate and Advanced Glaucoma</title>
      <link>https://trid.trb.org/View/1405267</link>
      <description><![CDATA[Purpose: To compare on-road driving performance of patients with moderate or advanced glaucoma to controls and evaluate factors associated with unsafe driving. Design: Case-control pilot study. Methods: A consecutive sample of 21 patients with bilateral moderate or advanced glaucoma from Washington University, St Louis, Missouri and 38 community-dwelling controls were enrolled. Participants, aged 55–90 years, underwent a comprehensive clinical evaluation by a trained occupational therapist and an on-road driving evaluation by a masked driver rehabilitation specialist. Overall driving performance of pass vs marginal/fail and number of wheel and/or brake interventions were recorded. Results:Fifty-two percent of glaucoma participants scored a marginal/fail compared to 21% of controls (odds ratio [OR], 4.1; 95% CI, 1.30–13.14; P = .02). Glaucoma participants had a higher risk of wheel interventions than controls (OR, 4.67; 95% CI, 1.03–21.17; P = .046). There were no differences detected between glaucoma participants who scored a pass vs marginal/fail for visual field mean deviation of the better (P = .62) or worse (P = .88) eye, binocular distance (P = .15) or near (P = .23) visual acuity, contrast sensitivity (P = .28), or glare (P = .88). However, glaucoma participants with a marginal/fail score performed worse on Trail Making Tests A (P = .03) and B (P = .05), right-sided Jamar grip strength (P = .02), Rapid Pace Walk (P = .03), Braking Response Time (P = .03), and identifying traffic signs (P = .05). Conclusions: Patients with bilateral moderate or advanced glaucoma are at risk for unsafe driving—particularly those with impairments on psychometric and mobility tests. A comprehensive clinical assessment and on-road driving evaluation is recommended to effectively evaluate driving safety of these patients.]]></description>
      <pubDate>Mon, 23 May 2016 09:49:29 GMT</pubDate>
      <guid>https://trid.trb.org/View/1405267</guid>
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      <title>GUIDELINES FOR EXAMINING THE DRIVER WITH VISUAL DIFFICULTY</title>
      <link>https://trid.trb.org/View/115312</link>
      <description><![CDATA[THE UNITED STATES PUBLIC HEALTH SERVICE HAS ISSUED GUIDELINES FOR STATE MEDICAL ADVISORY BOARDS TO USE IN THEIR ROLE AS CONSULTANTS TO THE MOTOR VEHICLE ADMINISTRATORS. THESE GUIDELINES CONCERN THE LICENSING OF MOTOR VEHICLE OPERATORS WITH IMPAIRED VISION. GROUPS OF DRIVERS DISCUSSED ARE DEFINED ACCORDING TO THE SEVERITY OF THEIR FUNCTIONAL IMPAIRMENT, AND CLASSIFIED BY TYPE OF VEHICLE LICENSE THEY ARE SEEKING: PASSENGER TRANSPORT, CARGO TRANSPORT, OR PRIVATE AUTO. THE VISION CATEGORIES DISCUSSED ARE: VISUAL ACUITY, VISUAL FIELDS, OCULAR MOTILITY, COLOR BLINDNESS, AND DARK ADAPTATION. CERTAIN CLASSES OF DRIVERS SHOULD BE REEVALUATED PERIODICALLY IN ORDER THAT IMPAIRMENT CHANGES MAY BE DETECTED. /HSL/]]></description>
      <pubDate>Thu, 07 Aug 2003 00:00:00 GMT</pubDate>
      <guid>https://trid.trb.org/View/115312</guid>
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