PubMed · 6236402
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B Gramberg-Danielsen. 1984. [Visual capacity and traffic].. https://pubmed.ncbi.nlm.nih.gov/6236402/
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OBJECTIVE: To examine the approaches to on-road assessment of driver competence in persons with brain impairment. Items examined were procedures, standardization, scoring methods, equipment requirements, and determination of fitness to drive. DATA SOURCES: All studies identified through citation or Medline search. STUDY SELECTION: The studies reviewed were those published from 1971 to the present that examined driving competence after brain impairment, as measured by a driving test. DATA EXTRACTION: A qualitative review of published studies reporting methodologies and authors' conclusions abstracted from sourced publications. DATA SYNTHESIS: Off-road driving assessments examine proficiency in operating a motor vehicle, but not ability to drive in traffic or accurate prediction of safe driving. On-road driving assessments have been used to examine the predictive validity of other driving assessment methods or the driving performance of subjects with brain impairment. Determining a subject's competence to drive is frequently a subjective evaluation. With a standardized driving test, a significant correlation between the objective driving score and the rater's global evaluation of fitness has been reported. CONCLUSION: Closed-course, off-road driving tests are recommended for examining vehicle operation skills and readiness for in-traffic evaluation only. This allows practice with any vehicle adaptations before on-road evaluation and identification of clients who are unsafe to proceed on-road. A practical driving test in traffic, with standardized route and driving maneuvers, is recommended for determining driver competence. Scoring of driving performance should be standardized, reliable, and specific, to identify deficient driving skills that may be amenable to training. Driving performance should be evaluated according to predefined criteria, and the judgment regarding competence should be closely related to this objective measure.
Driving is a highly prized activity for individuals of all ages. The decision to continue driving after a decrease in central acuity or visual field can be a source of anxiety for the individual and his or her family, as well as the ophthalmic practitioner. Although a great deal of research has been done concerning vision and driving, much controversy still surrounds this subject. This article reviews the literature concerning visual impairment and driving and makes suggestions for what should be considered when determining who should and should not continue to drive.
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