National Vision Research Institute, Australian College of Optometry, Melbourne, Australia.
Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Australia.
Clin Exp Optom. 2023 Aug;106(6):666-674. doi: 10.1080/08164622.2022.2105642. Epub 2022 Aug 1.
Eyecare professionals assess older adults against the vision requirements for driving and discuss this with them on a regular basis. Improved access to resources/training would be beneficial and help eyecare professionals navigate more difficult conversations about driving, e.g., following acute vision changes.
The numbers of drivers aged >65 years is increasing in many countries, in line with ageing populations. In most countries the onus is on the driver to self-monitor their vision for driving, by engaging in regular eye tests. Eyecare professionals therefore could play an important role in older driver decision-making about their fitness to drive. There is limited guidance for eyecare professionals regarding how to approach conversations with older drivers about their vision, and when these conversations should be had.
Semi-structured interviews were undertaken with eyecare professionals involved in vision assessments and decision-making about medical fitness to drive for older adults (optometrists, orthoptists, ophthalmologists). Framework analysis identified challenges and facilitators to conversations with older drivers about vision.
Twenty-six eyecare professionals from Australia (n = 17) and England (n = 9) participated from urban and regional/rural areas. Themes were divided into facilitators (clear standards and comprehensive testing; positive approach; preparation and patient self-awareness; relationships and trust; importance of multiple options in guiding a transition to driving retirement) and challenges (acute loss of visual function; limited self-awareness of the impact of visual problems on driving; and perceived lack of resources and need for training).
Eyecare professionals prefer to have early and regular conversations with older adults about their vision for driving. Acute visual field/acuity loss or onset of double vision, necessitating rapid changes to driving behaviour, were both identified as major challenges for eyecare professionals. Improved access to resources and training would be beneficial, to help eyecare professionals navigate these especially difficult conversations and signpost older drivers to appropriate support.
眼科保健专业人员根据驾驶的视觉要求评估老年人，并定期与他们讨论这个问题。更好地获取资源/培训将是有益的，并帮助眼科保健专业人员更轻松地进行有关驾驶的对话，例如，在视力发生急性变化时。
在许多国家，随着人口老龄化，年龄在 65 岁以上的驾驶员人数正在增加。在大多数国家，驾驶员有责任通过定期进行眼部检查来自我监测其驾驶视力。因此，眼科保健专业人员在老年人驾驶能力决策方面可以发挥重要作用。关于如何与老年驾驶员进行有关他们视力的对话，以及何时进行这些对话，眼科保健专业人员的指导有限。
对参与老年人视力评估和医疗驾驶能力决策的眼科保健专业人员（验光师、斜视师、眼科医生）进行了半结构化访谈。框架分析确定了与老年驾驶员进行有关视力的对话的挑战和促进因素。
来自澳大利亚（n=17）和英格兰（n=9）的 26 名眼科保健专业人员参与了此项研究，他们来自城市和城乡/农村地区。主题分为促进因素（明确的标准和全面的测试；积极的方法；准备和患者自我意识；关系和信任；在指导过渡到驾驶退休方面多种选择的重要性）和挑战（视力功能的急性丧失；对视觉问题对驾驶的影响的有限自我意识；以及资源的感知缺乏和培训的需求）。
眼科保健专业人员希望与老年人就其驾驶视力进行早期和定期的对话。急性视野/视力丧失或复视的出现，需要迅速改变驾驶行为，这对眼科保健专业人员来说都是重大挑战。更好地获取资源和培训将是有益的，以帮助眼科保健专业人员更轻松地进行这些特别困难的对话，并为老年驾驶员提供适当的支持。
