Driving Habits of Visually Impaired Drivers Who Use Bioptic Telescopes Alex Bowers, Doris Apfelbaum and Eli Peli

Bioptic Telescopes For people with reduced visual acuity Spectacle mounted Distance spotting Most of time look through carrier lens

Driving with Bioptic

Background Questionnaire survey Little data on driving habits of bioptic drivers Self-restriction of driving habits with onset of visual impairment is well documented (Ball et al, 1998; Owsley et al, 1999; Lyman et al; 2001; Keeffe et al, 2002; West et al, 2003; DeCarlo et al, 2003) Questionnaire survey Establish habits of bioptic drivers Impact of bioptic use on driving habits and quality of life

Methods Driving Habits Questionnaire (DHQ)1 Telephone interview 58 bioptic drivers from 12 states Median Range Age (yrs) 47 17 - 86 Bioptic driving (yrs) 8 0.25 - 32 Duration of impairment (yrs) 34 2 - 81 Visual acuity without bioptic 20/100 20/50 – 20/240 1. Owsley et al (1999) J. Gerontol A Biol Sci Med Sci; 54:M203-211

General driving habits Confident about driving: Drive same speed as the general flow 84% Rate quality of driving to be above average 72% Moderately or very confident driving with bioptic 88% But 60% used visual assistance (passenger) Reading traffic signs Identifying color of traffic light signals Warning of hazards ahead Help with directions or navigation

(US Dept Transportation, 2003) Distances driven Miles per week Furthest distance: 60% out of state 33% out of region Median: 200 miles per week Normally-sighted: 203 miles per week (US Dept Transportation, 2003)

Driving difficulty in 9 situations

Driving difficulty in 9 situations

Perceived driving difficulty and other self-restricting behaviors: Spearman’s r Low days driving per week -0.44** Limited furthest distance -0.33** Low weekly mileages -0.29* Slow speed relative to traffic flow -0.27* * p = 0.05; ** p =0.01

Impact of bioptic use on quality of life For subjects aged ≤ 65 years: 90% were employed & 85% drove to work

Is driving less restricted when a bioptic is used? Compared our results to previous studies that used Driving Habits Questionnaire for visually impaired driving without bioptics Hypothesis: Bioptic drivers would have less restricted habits than non-bioptic drivers with similar visual acuity of a similar age

Bioptic drivers compared to non-bioptic drivers with AMD1 Age Visual Acuity Bioptic CFL Bioptic drivers with central field loss over 55 yrs 11 75 ± 8 20/126 Non-Bioptic AMD1 Non-bioptic with age-related macular degeneration 30 76 ± 7 20/110 1. DeCarlo et al (2003) Optom Vis Sci; 80:207-213

General driving habits Bioptic CFL Non-Bioptic AMD Miles per week 45 10 Drive same speed as general flow (%) 73* 47* Quality of driving above average (%) 82* 57* * Chi square, p = 0.1

Percentage reporting no difficulty with driving

Percentage avoiding driving

Bioptic drivers compared to non-bioptic drivers with cataract1 and normal sight1 Age VA Bioptic Over 55 Bioptic drivers > 55 yrs 15 71 ± 10 20/120 Non-bioptic Cataract1 Non-bioptic, cataract > 55yrs 279 71 ± 6 20/34 Normal1 Normally sighted > 55yrs 105 67 ± 6 20/20 1. Owsley et al (1999) J. Gerontol A Biol Sci Med Sci; 54:M203-211

Percentage reporting driving difficulty * p < 0.03 *

Conclusions Bioptic drivers: Quality of life: Relatively unrestricted driving habits Low levels of driving avoidance due to vision impairment Less restricted driving habits and much lower levels of driving difficulty than non-bioptic drivers with AMD (similar age and VA) Self-restrict in relation to perceived limitations Quality of life: is enhanced through being permitted to drive with a bioptic

Acknowledgements Subject recruitment Chuck Huss (West Virginia Low Vision Driving Program) Renee Paquin (New Hampshire Association for the Blind) Bioptic Drivers Network (www.biopticdriving.org) Supported in part by NIH grant #EY12890