Hemianopic and Quadrantanopic Field Loss, Eye and Head Movements, and Driving

Wood, Joanne M.; McGwin, Gerald; Elgin, Jennifer; Vaphiades, Michael S.; Braswell, Ronald A.; DeCarlo, Dawn K.; Kline, Lanning B.; Owsley, Cynthia

doi:10.1167/iovs.10-6296

Cited by 65 publications

(118 citation statements)

References 21 publications

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“…Wood et al 6 tested in a real life situation and established an evaluation of driving performance of patients with visual field defects. Head-and eye-movements were analyzed via video and post-test scoring by two independent researchers, thus dealing with inter-rater-reliability.…”

Section: Discussionmentioning

confidence: 99%

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects

Hamel

Kraft

Ohl

et al. 2012

JoVE

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Patients suffering from homonymous hemianopia after infarction of the posterior cerebral artery (PCA) report different degrees of constraint in daily life, despite similar visual deficits. We assume this could be due to variable development of compensatory strategies such as altered visual scanning behavior. Scanning compensatory therapy (SCT) is studied as part of the visual training after infarction next to vision restoration therapy. SCT consists of learning to make larger eye movements into the blind field enlarging the visual field of search, which has been proven to be the most useful strategy 1 , not only in natural search tasks but also in mastering daily life activities 2 . Nevertheless, in clinical routine it is difficult to identify individual levels and training effects of compensatory behavior, since it requires measurement of eye movements in a head unrestrained condition. Studies demonstrated that unrestrained head movements alter the visual exploratory behavior compared to a headrestrained laboratory condition 3 . Martin et al. 4 and Hayhoe et al. 5 showed that behavior demonstrated in a laboratory setting cannot be assigned easily to a natural condition. Hence, our goal was to develop a study set-up which uncovers different compensatory oculomotor strategies quickly in a realistic testing situation: Patients are tested in the clinical environment in a driving simulator. SILAB software (Wuerzburg Institute for Traffic Sciences GmbH (WIVW)) was used to program driving scenarios of varying complexity and recording the driver's performance. The software was combined with a head mounted infrared video pupil tracker, recording head-and eye-movements (EyeSeeCam, University of Munich Hospital, Clinical Neurosciences).The positioning of the patient in the driving simulator and the positioning, adjustment and calibration of the camera is demonstrated. Typical performances of a patient with and without compensatory strategy and a healthy control are illustrated in this pilot study. Different oculomotor behaviors (frequency and amplitude of eye-and head-movements) are evaluated very quickly during the drive itself by dynamic overlay pictures indicating where the subjects gaze is located on the screen, and by analyzing the data. Compensatory gaze behavior in a patient leads to a driving performance comparable to a healthy control, while the performance of a patient without compensatory behavior is significantly worse. The data of eye-and head-movement-behavior as well as driving performance are discussed with respect to different oculomotor strategies and in a broader context with respect to possible training effects throughout the testing session and implications on rehabilitation potential.

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Section: Discussionmentioning

confidence: 99%

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects

Hamel

Kraft

Ohl

et al. 2012

JoVE

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“…The system also included four video cameras that recorded the driver and the external driving environment; two of the cameras were positioned within the vehicle and directed toward the driver and two faced forward and were positioned on the roof of the vehicle. 19 The driving performance of each participant was assessed along the same route under in-traffic conditions consisting of 14.6 miles of noninterstate driving in residential and commercial areas of a city. A CDRS who was also a licensed occupational therapist with low vision specialty certification sat in the front passenger seat of the vehicle; at the time of the study the CDRS had 12 years of clinical experience in driving assessment and rehabilitation of patients with a wide variety of medical conditions.…”

Section: Methodsmentioning

confidence: 99%

“…These outcome measures were provided as a function of the speeds driven in the ranges of 0 to 15 miles per hour (mph), 15 to 35 mph, 35 to 55 mph, and 55 mph and over, as described previously. 19 The videos of the external vehicle environment and driver were analyzed by an independent rater who was masked to the driving category (safe/unsafe) of each of the participants. The rater viewed the video recordings of the internal vehicle environment for each participant to record the number of head movements, including spotting through the telescope for the bioptic drivers.…”

Section: Scoring Of Instrumented Vehicle Output and Video Recordingsmentioning

confidence: 99%

Characteristics of On-Road Driving Performance of Persons With Central Vision Loss Who Use Bioptic Telescopes

Wood

McGwin

Elgin

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To compare the on-road driving performance of visually impaired drivers using bioptic telescopes with age-matched controls.METHODS. Participants included 23 persons (mean age ¼ 33 6 12 years) with visual acuity of 20/63 to 20/200 who were legally licensed to drive through a state bioptic driving program, and 23 visually normal age-matched controls (mean age ¼ 33 6 12 years). On-road driving was assessed in an instrumented dual-brake vehicle along 14.6 miles of city, suburban, and controlled-access highways. Two backseat evaluators independently rated driving performance using a standardized scoring system. Vehicle control was assessed through vehicle instrumentation and video recordings used to evaluate head movements, lane-keeping, pedestrian detection, and frequency of bioptic telescope use.RESULTS. Ninety-six percent (22/23) of bioptic drivers and 100% (23/23) of controls were rated as safe to drive by the evaluators. There were no group differences for pedestrian detection, or ratings for scanning, speed, gap judgments, braking, indicator use, or obeying signs/signals. Bioptic drivers received worse ratings than controls for lane position and steering steadiness and had lower rates of correct sign and traffic signal recognition. Bioptic drivers made significantly more right head movements, drove more often over the right-hand lane marking, and exhibited more sudden braking than controls.CONCLUSIONS. Drivers with central vision loss who are licensed to drive through a bioptic driving program can display proficient on-road driving skills. This raises questions regarding the validity of denying such drivers a license without the opportunity to train with a bioptic telescope and undergo on-road evaluation.

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“…However, in other states they may be permitted to drive, and in some countries (e.g., Belgium, Netherlands, Switzerland, UK, Canada) they may be licensed after taking a specialized road test. Individuals with HH may be able to compensate for their hemifield loss by scanning with eye and/or head movements into the blind field; however, there is only limited information about their scanning behaviors when driving Papageorgiou et al, 2012;Wood et al, 2011). In an on-road study of drivers with HH (Bowers et al, 2012), the majority of detection failures occurred at intersections, suggesting that many of the participants did not scan effectively; however, head and eye movements were not recorded.…”

Section: Background and Objectivesmentioning

confidence: 99%

Pilot Study of Gaze Scanning and Intersection Detection Failures by Drivers with Hemianopia

Bowers

Alberti

Hwang

et al. 2015

Proceedings of the 8th International Driving Symposium on Human Factors in Driver Assessment, Training, and Vehicle Design: Dri

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Summary:In a prior study, intersection detection failures of individuals with hemianopia were strongly associated with inadequate head scanning; however, eye position was not tracked. In this pilot study, we tracked eye and head movements, and examined the relationship between gaze scanning and detection of pedestrians at intersections in a driving simulator. Gaze scan deficits, in particular not scanning sufficiently far into the blind hemifield, were the main reason for detection failures at the extreme edge of the clear-sight triangle in the blind hemifield. In addition, the gaze data revealed detection failures due to looked-but-failed-to-see events. The results suggest that HH drivers may be at increased risk for collisions at intersections. BACKGROUND AND OBJECTIVES

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Hemianopic and Quadrantanopic Field Loss, Eye and Head Movements, and Driving

Cited by 65 publications

References 21 publications

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects

Characteristics of On-Road Driving Performance of Persons With Central Vision Loss Who Use Bioptic Telescopes

Pilot Study of Gaze Scanning and Intersection Detection Failures by Drivers with Hemianopia

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