A New Method for Estimating Effects of Visual Field Loss in a Panoramic Driving Environment

Glaucoma is a key cause of peripheral visual field loss and increases risk of a vehicle crash. Patients may be unaware of their visual loss and of hazards in the driving panorama. Standard clinical automated perimetry, the “gold standard” for monitoring glaucoma progression, lacks external validity to evaluate functional effect of visual field loss in driving environments. We developed and piloted a new technique to study the effects of glaucoma in a panoramic (290 forward FOV) simulated driving environment. Preliminary results in 11 drivers (7 with glaucoma and 4 with suspected glaucoma): (1) demonstrate the relationship between standard clinical perimetry and driving simulator visual fields, (2) replicate clinical evidence of glaucoma-related peripheral visual field loss, and (3) show added visual field loss due to visual occlusion by in-cab geometry.