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- Baskaran, Karthikeyan, Senior Lecturer, 1983-, et al.
(author)
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Closed circuit driving performance in persons with quadrantanopia and hemianopia in Sweden
- 2016
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In: Scandinavian Journal of Optometry and Visual Science. - 1891-0882 .- 1891-0890. ; 9:2, s. 14-
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Journal article (peer-reviewed)abstract
- In Sweden, persons with homonymous visual field defects (HVFDs) are not allowed to drive and usually their driving licences are revoked. Although earlier studies (de Haan et al. 2014; Elgin et al. 2010) have shown that HVFDs do not necessarily impair practical fitness to drive, the Swedish transport agency does not allow them any on-road driving testing to prove their practical fitness to drive. The aim of this study was to evaluate driving performance in participants with visual field defects after acquired brain injury in a closed circuit driving track. Eleven former drivers with varying degrees of quadrantanopia and hemianopia after acquired brain damage were recruited for this study from the stroke rehabilitation department at Kalmar County Hospital. The median age of the participants was 55 years and their age ranged from 37 to 73 years. Driving performance was assessed by two experienced driving instructors. They graded the participants on a scale from 1 (major faults) to 5 (excellent) on the following five categories: manoeuvring the vehicle, risk assessment, traffic rules, visual scanning and situation awareness. The subject would pass the driving test only if they had scored 3 or more in each category. The subjects who passed the closed circuit driving track test were evaluated further with a driving simulator. Five (45%) out of 11 participants passed the driving test and were adjudged as fit to drive. The remaining six (55%) participants failed in at least one category. Three failed in visual scanning, two failed in manoeuvring and one failed in both the aforementioned categories as well as risk assessment. Three subjects who passed the closed circuit driving track test were also evaluated in a driving simulator. Out of the three subjects, only one was able to complete and pass the evaluation while the remaining two participants aborted the evaluation due to simulator sickness. Homonymous visual field defects do not necessarily impair fitness to drive. Therefore, an on-road assessment of practical fitness to drive should be allowed in Sweden for this population in the near future. The decision on practical fitness to drive cannot be based solely on the presence of visual field defects. A rehabilitation program aimed at improving safe driving should be put into practice with an on-road driving training and assessment procedure. It should be developed and implemented by experienced traffic inspectors as a complementary part of the decision to either issue or revoke a driving licence for this population.
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