As driving depends significantly on peripheral vision, contrast sensitivity, and rapid visual processing, persons with glaucomatous abnormalities may suffer issues such as trouble identifying dangers, delayed reaction times, and poor lane maintaining. These limits present serious safety issues, both for impacted drivers and others on the road.
As global populations age and glaucoma becomes more widespread, knowing how specific patterns and severities of visual field loss impact driving ability is critical. This insight can assist guide clinical counseling, inform licensing rules, and enable the development of focused treatments to retain mobility while guaranteeing road safety. The research on the effects of glaucomatous VF loss on driving ability, the degree of driving limitation and cessation, and the risk of motor vehicle accidents (MVCs) is qualitatively analyzed in this systematic review.
Using keywords like "glaucoma," "visual field defect/disorder," and "driving," a search was done for studies published between 2003 and 2023 across MEDLINE and Embase (via Ovid), PubMed, the Cochrane Library, and Web of Science. The results were then screened based on predetermined inclusion criteria. Data on research design, visual field defect features, participant characteristics, driving performance metrics, and associated outcomes were gathered from the qualifying studies.
Initial search returned 835 studies, with 20 research selected. Three more papers were included by hand-searching, with a total of 23 studies included for final evaluation. Poorer driving performance, including longer reaction times to road dangers, a reduced capacity for lane management, and more difficulties driving at night, was the outcome of moderate to severe VF abnormalities.
When compared to patients with milder, unilateral glaucoma, individuals with more severe VF abnormalities and bilateral glaucoma were more inclined to restrict or stop driving. A higher probability of MVCs was linked to a more severe VF loss.
Overall, individuals with moderate to severe glaucomatous VF loss and bilateral glaucoma tended to demonstrate lower driving ability when compared to persons with mild and unilateral illness. Higher rates of self-limitation and driving stoppage, as well as an increased risk of MVCs in both simulator and real-world contexts, were linked to more severe VF faults.
Source:
Toh, Z. H., Koh, S. Y. N., Yang, W. Y. L., Munro, Y. L., & Ang, B. C. H. (2025). The effect of glaucomatous visual field defects on driving: A systematic review. Journal of Glaucoma, 34(11), 837–852. https://doi.org/10.1097/IJG.0000000000002633
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