Assessing visual fields for driving in patients with paracentral scotomata

C.M. Chisholm, F.G. Rauscher, D.C. Crabb, Leon N. Davies, Mark C.M. Dunne, D.F. Edgar, J.A. Harlow, M. James-Galton, A. Petzold, G.T. Plant, A.C. Viswanathan, G.J. Underwood, J.L. Barbur

Research output: Contribution to journalArticle

Abstract

Background: The binocular Esterman visual field test (EVFT) is the current visual field test for driving in the UK. Merging of monocular field tests (Integrated Visual Field, IVF) has been proposed as an alternative for glaucoma patients. Aims: To examine the level of agreement between the EVFT and IVF for patients with binocular paracentral scotomata, caused by either ophthalmological or neurological conditions, and to compare outcomes with useful field of view (UFOV) performance, a test of visual attention thought to be important in driving. Methods: 60 patients with binocular paracentral scotomata but normal visual acuity (VA) were recruited prospectively. Subjects completed and were classified as “pass” or “fail” for the EVFT, IVF and UFOV. Results: Good agreement occurred between the EVFT and IVF in classifying subjects as “pass” or “fail” (kappa?=?0.84). Classifications disagreed for four subjects with paracentral scotomata of neurological origin (three “passed” IVF yet “failed” EVFT). Mean UFOV scores did not differ between those who “passed” and those who “failed” both visual field tests (p?=?0.11). Agreement between the visual field tests and UFOV was limited (EVFT kappa?=?0.22, IVF kappa 0.32). Conclusions: Although the IVF and EVFT agree well in classifying visual fields with regard to legal fitness to drive in the UK, the IVF “passes” some individuals currently classed as unfit to drive due to paracentral scotomata of non-glaucomatous origin. The suitability of the UFOV for assessing crash risk in those with visual field loss is questionable.
LanguageEnglish
Pages225-230
Number of pages6
JournalBritish Journal of Ophthalmology
Volume92
Issue number2
DOIs
Publication statusPublished - Feb 2008

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Scotoma
Visual Field Tests
Visual Fields
Glaucoma
Visual Acuity

Keywords

  • binocular Esterman visual field test
  • driving
  • Merging of monocular field tests
  • glaucoma

Cite this

Chisholm, C.M. ; Rauscher, F.G. ; Crabb, D.C. ; Davies, Leon N. ; Dunne, Mark C.M. ; Edgar, D.F. ; Harlow, J.A. ; James-Galton, M. ; Petzold, A. ; Plant, G.T. ; Viswanathan, A.C. ; Underwood, G.J. ; Barbur, J.L. / Assessing visual fields for driving in patients with paracentral scotomata. In: British Journal of Ophthalmology. 2008 ; Vol. 92, No. 2. pp. 225-230.
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title = "Assessing visual fields for driving in patients with paracentral scotomata",
abstract = "Background: The binocular Esterman visual field test (EVFT) is the current visual field test for driving in the UK. Merging of monocular field tests (Integrated Visual Field, IVF) has been proposed as an alternative for glaucoma patients. Aims: To examine the level of agreement between the EVFT and IVF for patients with binocular paracentral scotomata, caused by either ophthalmological or neurological conditions, and to compare outcomes with useful field of view (UFOV) performance, a test of visual attention thought to be important in driving. Methods: 60 patients with binocular paracentral scotomata but normal visual acuity (VA) were recruited prospectively. Subjects completed and were classified as “pass” or “fail” for the EVFT, IVF and UFOV. Results: Good agreement occurred between the EVFT and IVF in classifying subjects as “pass” or “fail” (kappa?=?0.84). Classifications disagreed for four subjects with paracentral scotomata of neurological origin (three “passed” IVF yet “failed” EVFT). Mean UFOV scores did not differ between those who “passed” and those who “failed” both visual field tests (p?=?0.11). Agreement between the visual field tests and UFOV was limited (EVFT kappa?=?0.22, IVF kappa 0.32). Conclusions: Although the IVF and EVFT agree well in classifying visual fields with regard to legal fitness to drive in the UK, the IVF “passes” some individuals currently classed as unfit to drive due to paracentral scotomata of non-glaucomatous origin. The suitability of the UFOV for assessing crash risk in those with visual field loss is questionable.",
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author = "C.M. Chisholm and F.G. Rauscher and D.C. Crabb and Davies, {Leon N.} and Dunne, {Mark C.M.} and D.F. Edgar and J.A. Harlow and M. James-Galton and A. Petzold and G.T. Plant and A.C. Viswanathan and G.J. Underwood and J.L. Barbur",
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Chisholm, CM, Rauscher, FG, Crabb, DC, Davies, LN, Dunne, MCM, Edgar, DF, Harlow, JA, James-Galton, M, Petzold, A, Plant, GT, Viswanathan, AC, Underwood, GJ & Barbur, JL 2008, 'Assessing visual fields for driving in patients with paracentral scotomata' British Journal of Ophthalmology, vol. 92, no. 2, pp. 225-230. https://doi.org/10.1136/bjo.2007.129726

Assessing visual fields for driving in patients with paracentral scotomata. / Chisholm, C.M.; Rauscher, F.G.; Crabb, D.C.; Davies, Leon N.; Dunne, Mark C.M.; Edgar, D.F.; Harlow, J.A.; James-Galton, M.; Petzold, A.; Plant, G.T.; Viswanathan, A.C.; Underwood, G.J.; Barbur, J.L.

In: British Journal of Ophthalmology, Vol. 92, No. 2, 02.2008, p. 225-230.

Research output: Contribution to journalArticle

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T1 - Assessing visual fields for driving in patients with paracentral scotomata

AU - Chisholm, C.M.

AU - Rauscher, F.G.

AU - Crabb, D.C.

AU - Davies, Leon N.

AU - Dunne, Mark C.M.

AU - Edgar, D.F.

AU - Harlow, J.A.

AU - James-Galton, M.

AU - Petzold, A.

AU - Plant, G.T.

AU - Viswanathan, A.C.

AU - Underwood, G.J.

AU - Barbur, J.L.

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