Car Driving Performance in Hemianopia: An On-Road Driving Study

Abstract

Training programs aimed at improving practical fitness to drive in people with HH should focus on improving both visual scanning, as well as driving aspects such as steering stability, speed adaptation, and anticipating environmental changes.

Driving with homonymous visual field loss: a review of the literature

“…Furthermore, the European Driving Licence Directive permits all member countries to make exceptions for persons with stable visual loss, who do not meet the minimum field requirements. The process typically involves a thorough medical and vision examination before the applicant is permitted to take a specialised road test to demonstrate their practical fitness to drive . It appears that this provision has been implemented in only a minority of European Union countries, including Belgium, the Netherlands and the UK .…”

“…The process typically involves a thorough medical and vision examination before the applicant is permitted to take a specialised road test to demonstrate their practical fitness to drive . It appears that this provision has been implemented in only a minority of European Union countries, including Belgium, the Netherlands and the UK . In addition, some countries outside the European Union also operate exceptional‐case programs (for example, Switzerland and Canada) and the vision standards for driving in Australia include a provision that a conditional licence may be considered when a driver does not meet the visual field requirements for an unconditional licence.…”

“…Several studies have evaluated driving performance of persons with HFDs on open‐road test routes along public roads, either for research purposes or as part of an exceptional‐case program (Table ). The tests were usually conducted in a dual‐control car with a driving examiner or rehabilitation specialist in the front passenger seat . The test routes were typically about 45 minutes in duration with a variety of traffic environments (residential, city, highway) and manoeuvres .…”

“…Drivers that failed a road test were most commonly reported to have problems with lane position, steering stability and inadequate viewing (scanning) behaviour (Table ), which in some cases required a steering or braking intervention by the driving examiner …”

“…Consistent with these results, HFD drivers had significantly greater lateral lane position variability and made more lane boundary crossings than normally sighted drivers in a driving simulator. Moreover, problems with unstable steering and unacceptable lane positioning were more common among HFD drivers who failed a road test than among those who passed . In a few cases, unstable steering was reported to occur when participants rated as unsafe on the road test attempted to compensate for the field loss by visual scanning toward the affected side …”