Patients with glaucoma who have moderate or severe visual field impairment in the central 24 degrees radius field in the worse-functioning eye are at increased risk of involvement in a vehicle crash.

Older persons with glaucoma drive at least as safely as, if not more safely than, older persons without glaucoma.

Summary:This study sought to evaluate the association between visual field defects in the central 24° field and motor vehicle collisions (MVC) among patients with glaucoma. A case-control study was conducted on glaucoma patients aged 55 and older being treated at three university-affiliated eye care practices. Cases were patients who sustained a police-reported motor vehicle collision (MVC); controls were those who did not experience a MVC. For each patient, an Advanced Glaucoma Intervention Study (AGIS) score was calculated on automated visual fields collected with the 24-2 or 30-2 programs. Additionally, demographic, behavioral, driving and clinical characteristics were obtained via chart abstractions and a patient telephone survey. With respect to the better eye AGIS score (defined according to AGIS score), compared to patients with no visual field defect, those with severe defects (scores 12-20) had an increased risk of MVC (odds ratio [OR] 3.2, 95% confidence interval [CI] 0.9-10.4), although this association was not statistically significant (p=0.0576). Moderate (6-11) or minor field defects (1-5) in the better eye were not associated with the risk of crash involvement. For the worse eye, patients with moderate and severe field defects were at significantly increased risk of a MVC (OR 3.6, respectively) compared to those with no defects. Minor field defects in the worse eye did not increase MVC risk (OR 1.3, 95% CI 0.5-3.4). Glaucoma patients with moderate or severe visual field impairment in the central 24° radius field in the worse functioning eye are at increased risk for involvement in a vehicle crash.

Pericardium is a biomaterial widely used for covering the outflow tubes of glaucoma drainage devices. Recently, glycerol preserved cornea has been introduced as an alternative that offers durability and improved cosmesis because of its clarity. We retrospectively reviewed 262 patients in the University of Alabama Birmingham Glaucoma Service who underwent shunt procedures using either cornea tissue or pericardium to cover the tube. The primary outcome measure was the number of erosions of the covering material. Nine out of 101 (8.9%) patients in the pericardium covered group experienced an erosion compared with 3 out of 161 (1.9%) in the cornea covered group. A significant difference was reached with P=0.0125. Median follow-up was 440 days for the cornea group and 331 days for the pericardium group. The type of glaucoma (primary open-angle glaucoma vs. secondary glaucoma) was not associated with the risk of erosion (odds ratio, 0.501; 95% confidence interval, 0.204-1.234). The median time to exposure was 252 days in the pericardium group and 440 days in the cornea group (P=0.0017).