Older Drivers and Glaucoma in India: Driving Habits and Crash Risks

Précis: In India, older drivers with glaucoma show greater driving difficulty but are not involved in higher number of on-road accidents. To achieve balance between safety aspects and independence for drivers with glaucoma is important. Purpose: The purpose of this study was to analyze driving habits of patients with glaucoma and to compare their driving behavior, driving difficulties, and accident rates with nonglaucoma controls. Patients: Patients with glaucoma aged older than 40 years were recruited. Subjects with best-corrected visual acuity ≤6/24 in the better-seeing eye and those having primary eye disorder other than glaucoma were excluded. Age-matched nonglaucoma controls were recruited. Subjects with clinically significant cataract and/or with best-corrected visual acuity ≤6/24 in both eyes were excluded. All cases and controls were legally licensed to drive. Materials and Methods: In this study, Driving Habits Questionnaire was used. Collected data were statistically analyzed using SAS, version 9.2 (GLM procedure), and IBM SPSS, version 22. P-values <0.05 were considered statistically significant. Results: All controls and 84% (n=84/100) of cases were current drivers. Among them, 16% (n=16/100) cases had stopped driving, of which 31.25% (n=5/16) had stopped because of self-reported ocular causes. Cases drove lesser number of days per week (P=0.001) and had more driving dependence on other drivers (44%, n=37/84) compared with controls. Glaucoma was significantly associated with driving difficulty in the rain, in rush-hour traffic, and at night. Comparing driving difficulty scores and visual field index within glaucoma group showed statistical significance [F(1,82)=22.12, P<0.001]. Composite scores of driving difficulty (P<0.001) and driving space (P=0.003) between the 2 groups showed strong statistical significance. Controls had higher number of self-reported accidents (P<0.001). Conclusions: Patients with glaucoma show greater driving difficulty, self-regulate their driving behavior, and restrict their driving. Older patients with glaucoma in India are not involved in higher rates of on-road crash risks compared with nonglaucoma drivers.