Impact of Glaucoma on Driving

Posted on: March 31st, 2024 by Our Team

Patients diagnosed with glaucoma, even at an early stage of the disease are at increased risk of driving that could lead to involvement in car accidents. It is known that glaucoma can decrease contrast sensitivity, motion detection, color perception, peripheral vision, and depth perception, all even at an early stage of the disease process. Comorbidities and medications coupled with the fact that most patients with glaucoma are older, all can exacerbate the problem.

There have been many studies to identify the effects of glaucoma on driving ability. Close to two decades ago, researchers reported that patients with advanced glaucoma are 3.6 times more likely to have a motor vehicle accident compared to those with no visual field defects (1), while another study found that risk to be almost doubled. (2) An additional group found that visual field loss exceeding 20 points on binocular visual fields and increased glare sensitivity were significant predictors of motor vehicle accidents (3).

A study of moderate-to-advanced glaucoma found that 52% of patients had marginal/failed road tests compared to 21% of age-matched controls (4), specifically decreased braking response time and decreased ability to identify traffic signs.

Risk Factors to Consider

• Significant increase when both central and peripheral vision have deteriorated
• Comorbidities such as diabetes, heart disease and medications can have negative visual effects.

Our physicians will begin discussions about glaucoma and driving early in the disease stage and follow up with occasional reminders.  Patients should be aware that senior driving courses and increased use of taxi and ride-sharing services can mitigate risk.

1. Swanson MW, Scilley K, Liu B, et al, The nursing home minimum data set for vision and vision function, Invest Ophthalmol Vis Sci 2007
2. Haymes SA, LeBlanc RP, Nicolela MT, et al.  Risk of falls and motor vehicle collisions in glaucoma, Invest Ophthalmol Vis Sci 2007
3. Rubin GS, Ng ESW, Bandeen-Roche K, et al.  The SEE Study. Invest Ophthalmol Vis SCi 2007
4. Bhorade AM, Ym VH, Barco P, et al. On-road driving performance of patients with bilateral moderate and advanced glaucoma, Am J Ophthalm