Hazard Detection by Drivers with Paracentral Homonymous Field Loss: A Small Case Series

Bronstad, P. Matthew; Bowers, Alex R.

doi:10.4172/2155-9570.s5-001

Cited by 17 publications

(23 citation statements)

References 14 publications

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“…The rate of failing to head scan to an incoming road on the blind side was no less than that of the NV drivers for the corresponding side. Taken together with the results of prior studies, 1,2,11,15,31 the findings of the present study suggest that scanning patterns employed by some HH drivers may be insufficient for safe driving and that they might benefit from training tailored to the specific problem areas identified here.…”

Section: Figuresupporting

confidence: 79%

Driving With Hemianopia: IV. Head Scanning and Detection at Intersections in a Simulator

Bowers¹,

Ananyev²,

Mandel³

et al. 2014

Invest. Ophthalmol. Vis. Sci.

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Section: Figuresupporting

confidence: 79%

Driving With Hemianopia: IV. Head Scanning and Detection at Intersections in a Simulator

Bowers¹,

Ananyev²,

Mandel³

et al. 2014

Invest. Ophthalmol. Vis. Sci.

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“…Response to unexpected blindside events was selected as the primary measure of the effects of the prism glasses for two reasons. Firstly, reactions to potential pedestrian hazards in driving simulator studies had proven to be a sensitive measure of the effects of a variety of types of visual field loss [15, 16, 39]. Secondly, data from two on-road studies of drivers with peripheral field loss due to glaucoma had demonstrated the possibility of using reactions to unexpected hazards as an outcome measure in open-road evaluations.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Evaluation of On-Road Detection Performance by Drivers with Hemianopia Using Oblique Peripheral Prisms

Bowers

Tant

Peli

2012

Stroke Research and Treatment

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Aims. Homonymous hemianopia (HH), a severe visual consequence of stroke, causes difficulties in detecting obstacles on the nonseeing (blind) side. We conducted a pilot study to evaluate the effects of oblique peripheral prisms, a novel development in optical treatments for HH, on detection of unexpected hazards when driving. Methods. Twelve people with complete HH (median 49 years, range 29–68) completed road tests with sham oblique prism glasses (SP) and real oblique prism glasses (RP). A masked evaluator rated driving performance along the 25 km routes on busy streets in Ghent, Belgium. Results. The proportion of satisfactory responses to unexpected hazards on the blind side was higher in the RP than the SP drive (80% versus 30%; P = 0.001), but similar for unexpected hazards on the seeing side. Conclusions. These pilot data suggest that oblique peripheral prisms may improve responses of people with HH to blindside hazards when driving and provide the basis for a future, larger-sample clinical trial. Testing responses to unexpected hazards in areas of heavy vehicle and pedestrian traffic appears promising as a real-world outcome measure for future evaluations of HH rehabilitation interventions aimed at improving detection when driving.

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“…A large screening study found accident rates for drivers with significant visual field loss in both eyes to be twice that of those with normal visual fields or with monocular field loss. 18 While this earlier study predominantly recorded peripheral field loss, binocular central field loss 19 and even just paracentral field loss 20 can also affect driving performance. The volume scotomas we addressed here are all central or paracentral.…”

Section: Discussionmentioning

confidence: 86%

Volume Perimetry

Satgunam¹,

Apfelbaum

Peli

2012

Optometry and Vision Science

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Purpose Volume scotomas are three-dimensional regions of space that are not visible to the observer. Volume perimetry maps volume scotomas. Volume scotomas predicted from combining monocular visual fields assume known fixation locus (mainly foveal). However fixation loci are not always known, especially with central field loss. Here we demonstrate methods for measuring and calculating volume scotomas and discuss their practical implications. Methods Three patients (bitemporal hemianopia, binasal scotoma, and central field loss (CFL)) were evaluated. Slices through the volume scotomas were measured at three distances: at the plane of fixation, at a plane anterior to fixation (representing anterior volume perimetry), and a plane posterior to fixation (representing posterior volume perimetry). For anterior volume perimetry, patients fixated on a screen 100cm away through a beamsplitter that reflected the perimetric stimulus (at 50cm). For posterior volume perimetry, patients fixated on a near target (50cm) while perimetric stimuli were presented on a screen 150cm beyond the fixation. At the plane of fixation, monocular visual fields under binocular viewing conditions were measured using a computerized dichoptic perimeter. Results Posterior and anterior volume scotomas were documented in patients with bitemporal hemianopia and binasal scotomas respectively. The CFL patient demonstrated both anterior and posterior volume scotomas. Scotoma magnitude was considered to determine its effect on visual function. Conclusions Direct measurement of volume scotomas can be performed. Anterior and posterior volume visual fields can vary substantially from conventional binocular perimetry measured at the fixation plane, revealing blind areas not otherwise identified. These volume scotomas are likely to impair functional vision such as driving (for bitemporal hemianopes) and near work with small hand tools (for binasal scotomas). Patients with CFL will have impaired functional vision for both distance and near tasks. Consideration of volume scotomas can help provide more effective vision rehabilitation and counseling.

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Hazard Detection by Drivers with Paracentral Homonymous Field Loss: A Small Case Series

Cited by 17 publications

References 14 publications

Driving With Hemianopia: IV. Head Scanning and Detection at Intersections in a Simulator

Driving With Hemianopia: IV. Head Scanning and Detection at Intersections in a Simulator

A Pilot Evaluation of On-Road Detection Performance by Drivers with Hemianopia Using Oblique Peripheral Prisms

Volume Perimetry

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