Wilde Craig, Poostchi Ali, Panos Georgios D, Hillman Jonathan G, MacNab Hamish K, Dua Harminder, Amoaku Winfried M, Vernon Stephen A
Department of Ophthalmology and Vision Sciences, Division of Clinical Neurosciences, B Floor, EENT Centre, Queen's Medical Centre, Nottingham University Hospitals and University of Nottingham, Nottingham, UK.
The Medical Centre, Station Avenue, Bridlington YO16 4LZ, UK.
J Ophthalmol. 2022 Sep 15;2022:8321948. doi: 10.1155/2022/8321948. eCollection 2022.
Self-assessment of driving fitness is mandatory in the United Kingdom. A paucity of data on visual function among drivers exists. We report prevalence of elderly drivers below legal visual acuity (VA) standard from a population study (The Bridlington Eye Assessment Project (BEAP)) conducted from 2002 to 2006. All residents aged ≥65 years were invited, 3459 undergoing structured interviews/ophthalmic examinations. Driving status was recorded, VA measured, and visual field (VF) testing performed. Outcomes were prevalence and characteristics of drivers below VA legal standard and prevalence of bilateral VF defects. Conditions causing reduced VA were explored and those with treatable conditions allowing visual improvement identified. Duration since last optometry review was recorded. Associations were explored using unpaired -tests for continuous and chi-squared for discrete variables. Logistic regression was used for multivariate analysis and to determine odd ratios in the final adjusted model. Statistical analysis was performed using Stata 14.0 (Stata Corp, Tx). Within this sample, 7.1% (95% CI 6.0-8.3) of drivers fell below the VA legal driving standard (6/12) in their better eye, with 20% not having seen an optometrist for 2 years, including 8.2% who had not attended for over 5 years. The percentage of drivers falling below the VA minimum increases with age reaching 22.8% (95% CI 13.7-35.3) among those aged 85-89 years. 7.2% (95% CI 6.2-8.6) of drivers had bilateral visual field defects. 93% of drivers with reduced VA below legal standard had a cataract, refractive error or both in at least one eye. Significant numbers of elderly drive with VA below legal standard, most having easily correctable causes. Poor attendance with optometrists appears commonplace. Public education raised awareness of legal driving standards and encouraged compliance are required. Regular eye tests, appropriate refractive correction, and cataract surgery when needed should be encouraged.
在英国，对驾驶适宜性进行自我评估是强制性的。关于驾驶员视觉功能的数据匮乏。我们报告了一项从2002年至2006年进行的人群研究（布里德灵顿眼部评估项目（BEAP））中低于法定视力（VA）标准的老年驾驶员的患病率。邀请了所有年龄≥65岁的居民，3459人接受了结构化访谈/眼科检查。记录驾驶状态，测量视力，并进行视野（VF）测试。结果是低于VA法定标准的驾驶员的患病率和特征以及双眼视野缺损的患病率。探讨了导致视力下降的情况，并确定了那些有可治疗情况且能改善视力的情况。记录了自上次验光检查以来的时间。使用连续变量的不成对t检验和离散变量的卡方检验来探讨相关性。逻辑回归用于多变量分析，并确定最终调整模型中的比值比。使用Stata 14.0（Stata公司，德克萨斯州）进行统计分析。在这个样本中，7.1%（95%置信区间6.0 - 8.3）的驾驶员较好眼的视力低于法定驾驶标准（6/12），20%的人两年内未看过验光师，其中8.2%的人超过五年未就诊。低于VA最低标准的驾驶员百分比随年龄增长而增加，在85 - 89岁的人群中达到22.8%（95%置信区间13.7 - 35.3）。7.2%（95%置信区间6.2 - 8.6）的驾驶员有双眼视野缺损。视力低于法定标准的驾驶员中，93%至少一只眼睛患有白内障、屈光不正或两者皆有。相当数量的老年人驾驶时视力低于法定标准，大多数有易于矫正的原因。看验光师的就诊率低似乎很常见。需要开展公众教育以提高对法定驾驶标准的认识并鼓励遵守。应鼓励定期进行眼部检查、进行适当的屈光矫正以及在需要时进行白内障手术。
