Older adult drivers with glaucoma are at a high risk for being at-fault in motor vehicle collisions, causing injury or death to themselves or others. However, the types of driving errors that place these individuals at risk and the relationship between their driving errors and their clinical profiles remain unclear. To address this need, we will study 125 drivers with varying severity of glaucoma and 55 control (non-glaucoma) drivers using an on-road driving test to assess driving behaviors in an objective, standardized, individualized, and real-life manner. Driving behavior will be measured by an in-car driving evaluator and a 2-camera telemetry system with modern sensors. A comprehensive clinical assessment of vision (e.g peripheral visual field loss) and non-vision (e.g cognition and mobility) factors associated with driving safety will be obtained to help characterize the relationship between these factors and driving errors.
The Specific Aims are to: 1) Identify the type and frequency of at-risk driving errors in glaucoma patients; 2) Determine vision and non-vision factors associated with at-risk driving errors in glaucoma patients; and 3) Identify effective compensatory strategies used by safe glaucoma drivers. A multidisciplinary team of experts (in glaucoma, gerontology, driving and low vision rehabilitation, instrumentation, epidemiology, and statistics) will provide integration of the multifactorial nature of safe and unsafe driving behavir in glaucoma patients. Multivariate methods will be used to develop a parsimonious model of vision and non-vision factors associated with driving errors. The expected outcome from this innovative project is to have identified 1. vision factors associated with at-risk driving errors n glaucoma patients that are amenable to interventions and 2. effective compensatory strategies currently used by safe glaucoma drivers. These two pieces of critical information will provide a foundation for defining interventions and designing studies to improve safety for glaucoma drivers. The long-term goal of our research is to develop and implement evidence-based vision rehabilitation programs to facilitate and prolong safe driving in older adults with glaucoma. Overall, these outcomes are anticipated to have an important public health benefit by reducing the risk of driving with glaucoma which will minimize morbidity and mortality and promote a sense of independence and overall well-being in older adults with glaucoma

Public Health Relevance

The proposed study directly addresses the goal of reducing injuries and fatalities due to motor vehicle collisions involving drivers with glaucoma. This research will not only help protect glaucoma patients and the public from unacceptable risk of harm from unsafe driving but will also promote safe driving, thereby helping to safeguard and prolong the independence and well-being of individuals with glaucoma.

National Institute of Health (NIH)
National Eye Institute (NEI)
Research Project (R01)
Project #
Application #
Study Section
Bioengineering of Neuroscience, Vision and Low Vision Technologies Study Section (BNVT)
Program Officer
Wiggs, Cheri
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Washington University
Schools of Medicine
Saint Louis
United States
Zip Code
Roe, Catherine M; Babulal, Ganesh M; Head, Denise M et al. (2017) Preclinical Alzheimer's disease and longitudinal driving decline. Alzheimers Dement (N Y) 3:74-82