Bioptic Telescopic Spectacles and Driving Performance: A Study in Texas

Lippmann, Otto; Corn, Anne L.; Lewis, M.C.

doi:10.1177/0145482x8808200506

Cited by 40 publications

(23 citation statements)

References 11 publications

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“…Small spectacle‐mounted telescopes, known as bioptics, enable people with reduced visual acuity to see details of distant objects and can be used as driving aids. There is some evidence for their safe use for driving, and also reports to the contrary . Despite their controversial use, bioptic telescopes are permitted for driving in 43 states in the US, the Netherlands, and Quebec, Canada.…”

Section: Introductionmentioning

confidence: 99%

“…Some claim that the ring scotoma impairs detection of important objects and events, while others argue that with a monocular telescope, the fellow (non‐telescope) eye can compensate . In conventional perimetry (bright spot on dimmer white background), the fellow eye can detect stimuli presented in the ring scotoma area when viewing binocularly . In more complex environments such as driving the difference in retinal images due to the magnification difference between the eyes may cause binocular rivalry or suppression, and therefore may prevent the fellow eye from compensating .…”

Section: Introductionmentioning

confidence: 99%

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Hazard detection with a monocular bioptic telescope

Doherty

Peli

Luo

2015

Ophthalmic Physiologic Optic

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Purpose The safety of bioptic telescopes for driving remains controversial. The ring scotoma, an area to the telescope eye due to the telescope magnification, has been the main cause of concern. This study evaluates whether bioptic users can use the fellow eye to detect in hazards driving videos that fall in the ring scotoma area. Methods Twelve visually impaired bioptic users watched a series of driving hazard perception training videos and responded as soon as they detected a hazard while reading aloud letters presented on the screen. The letters were placed such that when reading them through the telescope the hazard fell in the ring scotoma area. Four conditions were tested: no bioptic and no reading, reading without bioptic, reading with a bioptic that did not occlude the fellow eye (non-occluding bioptic), and reading with a bioptic that partially-occluded the fellow eye. Eight normally sighted subjects performed the same task with the partially occluding bioptic detecting lateral hazards (blocked by the device scotoma) and vertical hazards (outside the scotoma) to further determine the cause-and-effect relationship between hazard detection and the fellow eye. Results There were significant differences in performance between conditions: 83% of hazards were detected with no reading task, dropping to 67% in the reading task with no bioptic, to 50% while reading with the non-occluding bioptic, and 34% while reading with the partially occluding bioptic. For normally sighted, detection of vertical hazards (53%) was significantly higher than lateral hazards (38%) with the partially occluding bioptic. Conclusions Detection of driving hazards is impaired by the addition of a secondary reading like task. Detection is further impaired when reading through a monocular telescope. The effect of the partially-occluding bioptic supports the role of the non-occluded fellow eye in compensating for the ring scotoma.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hazard detection with a monocular bioptic telescope

Doherty

Peli

Luo

2015

Ophthalmic Physiologic Optic

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“…10 A few studies have examined motor vehicle collisions among bioptic drivers. [11][12][13][14][15][16][17] The results of these studies are inconsistent, which may be attributable to methodological problems such as small samples, uncertainty as to whether the driver was wearing the bioptic, and inappropriate comparison groups. A recent driver safety study by Vincent et al 18 collisions between a small group of bioptic drivers and two comparison groups and demonstrated elevated but not statistically significant increases.…”

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confidence: 99%

Visually Impaired Drivers Who Use Bioptic Telescopes: Self-Assessed Driving Skills and Agreement With On-Road Driving Evaluation

Owsley

McGwin

Elgin

et al. 2014

Invest. Ophthalmol. Vis. Sci.

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“…Taken together, the findings presented in our previous paper and this one suggest that a standard perimetric evaluation (as used in some prior bioptic telescope studies) is insufficient to determine the effect of the ring scotoma on detection ability and highlight the importance of using testing conditions that resemble real world use of devices. Performing perimetry using a patterned background and while engaged in an attention‐demanding central task, fellow‐eye detection performance in the area corresponding to the ring scotoma was reduced relative to performance in conditions more representative of conventional perimetry (uniform background and passive viewing of a central fixation cross).…”

Section: Discussionmentioning

confidence: 74%

The effect of strabismus on object detection in the ring scotoma of a monocular bioptic telescope

Doherty

Bowers

Luo

et al. 2013

Ophthalmic Physiologic Optic

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Purpose People with reduced visual acuity are permitted to drive with the aid of bioptic telescopes in the USA, The Netherlands, and Canada. When viewing through a monocular bioptic telescope, suppression of the deviating eye in strabismus may reduce the ability of the non-telescope eye to detect objects whose images fall in the ring scotoma area of the telescope eye, which could impair detection of traffic-relevant events. This ability to detect stimuli in the ring scotoma area was compared for strabismic and non-strabismic patients. Methods Ten strabismic and six non-strabismic patients with bilaterally reduced visual acuity (6/12 to 6/60) participated. A dichoptic perimeter presented stimuli to the fellow (non telescope) eye in the area of the ring scotoma under binocular viewing. Fellow-eye detection rates were determined with and without a bioptic, on uniform and patterned backgrounds, while performing passive (viewing a cross) and active (reading letters) fixation tasks. Results All strabismic patients were found to have anomalous retinal correspondence. Both non-strabismic and strabismic patients had lower fellow-eye detection rates on patterned than on uniform backgrounds, and while performing the active task. In addition, strabismic patients had lower detection with than without the bioptic on the patterned background. They also had a larger decrease in detection from the uniform to the patterned background than non-strabismic patients (26% vs 8%). Depending on the angle and direction of the deviation relative to the target side, strabismus either increased or decreased fellow-eye stimulus eccentricity on the retina. Larger detection rate reductions between the uniform and patterned backgrounds were associated with more eccentric stimulus locations (rho = 0.606, p = 0.013). Conclusions Both strabismic patients and non-strabismic patients were able to detect stimuli with the fellow eye in the ring scotoma area, demonstrating successful bi-ocular multiplexing. However, strabismic patients generally had a greater reduction in detection performance from the uniform to the patterned background than non-strabismic patients, which was accounted for in part by differences in stimulus eccentricities on the retina (that varied with the angle and direction of the strabismus). However, a study with a larger sample, including participants with strabismus and normal retinal correspondence, is needed before our findings can be generalized.

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Bioptic Telescopic Spectacles and Driving Performance: A Study in Texas

Cited by 40 publications

References 11 publications

Hazard detection with a monocular bioptic telescope

Hazard detection with a monocular bioptic telescope

Visually Impaired Drivers Who Use Bioptic Telescopes: Self-Assessed Driving Skills and Agreement With On-Road Driving Evaluation

The effect of strabismus on object detection in the ring scotoma of a monocular bioptic telescope

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