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Clin Exp Optom. 2016 Sep;99(5):435-40. doi: 10.1111/cxo.12432. Epub 2016 Jul 24.

Driving with central field loss III: vehicle control.

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Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
Department of Psychology, Villanova University, Villanova, Pennsylvania, USA.



Visual impairment associated with central field loss may make vehicle control more difficult due to the degraded view of the road. We evaluated how central field loss affects vehicle control in a driving simulator.


Nineteen participants with binocular central field loss (acuity 6/9 to 6/60) and 15 controls with normal vision drove 10 scenarios, each about eight to 12 minutes. Speed, lane offset and steering wheel reversal rate were measured on straights, left and right curves, along city (approximately 50 km/h) and rural highway (approximately 100 km/h) routes. Following distance was measured on two city straight segments.


Subjects with central field loss had higher steering wheel reversal rates (0.55 versus 0.45 reversals per second, p = 0.015), suggesting that the steering task was more demanding for them, requiring more steering corrections; however, they did not differ in other performance measures. Nearly all maintained a safe following distance, although they were more likely than controls with normal vision to lose sight of the lead car in scenarios that required following a car.


Most measures of vehicle control did not significantly differ between participants with central field loss and those with normal vision; however, the higher steering wheel reversal rates suggest that, in compensating for their vision impairment, drivers with central field loss had to allocate extra steering effort to maintain their lane position, which in turn could reduce attentional resources for other driving tasks.


age-related macular degeneration; driver's vision; low vision

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