Silveira Sue, Jolly Neryla, Heard Robert, Clunas Nathan J, Kay Lynnette
Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
Clin Exp Ophthalmol. 2007 Sep-Oct;35(7):612-20. doi: 10.1111/j.1442-9071.2007.01544.x.
The current licensing authority's (Austroads) visual field standards are met when a person demonstrates an intact visual field extending horizontally at least 120 degrees within 10 degrees above and below the horizontal midline. A person cannot be licensed unconditionally if they have a hemianopia, quadrantanopia or any significant visual field loss (scotoma) that is likely to impede driving performance. Despite fairly rigorous implementation of these vision standards by licensing authorities, there is little scientific evidence available to demonstrate that a driver will or will not be safe on road depending on the extent of their visual field.
This study was developed to examine if the current licensing authority vision standards predict safe on-road driver performance in a cohort of 100 senior drivers. The study consisted of four stages in which participants underwent on-road assessment by a multidisciplinary team including a driving instructor, orthoptist and occupational therapist; off-road occupational therapy cognitive skills assessment using the Visual Recognition Slide Test (VRST-USyd); off-road orthoptic assessment including history, visual acuity and visual fields; and feedback from the team regarding the participant's visual and driving status. Visual fields were assessed using both the Goldmann and Esterman tests. Correlations were calculated to determine the relationship between visual field results and on-road driving performance.
Generally it was found that visual field test results did not predict driving performance accurately for both participants with and without visual field loss.
The results bring into question the current Austroads visual field standards for safe driving.
当一个人在水平中线上下10度范围内展示出至少120度的完整水平视野时，当前的发证机构（澳大利亚道路局）的视野标准即被满足。如果一个人患有偏盲、象限盲或任何可能妨碍驾驶性能的明显视野缺损（暗点），则不能无条件获得驾照。尽管发证机构相当严格地执行了这些视力标准，但几乎没有科学证据表明根据驾驶员视野范围的大小其在道路上是否安全。
本研究旨在检验当前发证机构的视力标准能否预测100名老年驾驶员队列中的安全道路驾驶表现。该研究包括四个阶段，在此期间参与者接受了一个多学科团队的道路评估，该团队包括一名驾驶教练、一名视光师和一名职业治疗师；使用视觉识别幻灯片测试（VRST - USyd）进行的道路外职业治疗认知技能评估；包括病史、视力和视野的道路外视光评估；以及团队关于参与者视力和驾驶状态的反馈。使用戈德曼测试和埃斯特曼测试评估视野。计算相关性以确定视野结果与道路驾驶表现之间的关系。
总体而言，发现视野测试结果对于有视野缺损和无视野缺损的参与者均不能准确预测驾驶表现。
这些结果对当前澳大利亚道路局关于安全驾驶的视野标准提出了质疑。
