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Efty P. Stavrou, Joanne M. Wood, Diana Battistutta; Vision assessment of older drivers for relicensure. Journal of Vision 2005;5(8):156. doi: 10.1167/5.8.156.
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© ARVO (1962-2015); The Authors (2016-present)
Background: Older drivers have a high crash rate and this may be linked to vision changes with age. This study aimed to (i) compare older driver fatality rates across Australian states to determine whether crash rates were related to vision re-licensing procedures (ii) determine which visual tests Australian optometrists perform on older drivers presenting for visual assessment for licence renewal. Methods: State based age- and gender-stratified numbers of older driver fatalities for 2000–2003 were obtained from the Australian Transportation Safety Bureau database. Poisson regression analyses of fatality rates were considered by renewal frequency, adjusting for possible confounding variables of age, gender and year. All practising optometrists in Australia were surveyed on the visual tests they conduct in consultations relating to driving and their knowledge of vision requirements for older drivers. Results: For drivers aged 60–69 years, states with mandatory vision testing had a 25% (95% CI 0.32–1.77) lower fatality risk than those with no vision testing upon re-licensure. However, for drivers aged 70+ years, fatality risk was not significantly related to vision re-licensing strategies (RR=1.17, CI 0.64–2.13). Nearly all optometrists measured visual acuity as part of a vision assessment for re-licensing, however, only 20% routinely performed automated visual fields on older drivers, despite the Medical Standards for Licensing advocating automated visual fields as part of the vision standard. Conclusion: Vision assessment for re-licensure has a positive impact on driver fatality rates for those between 60–69 years, however, the primary test of vision is visual acuity. Optometrists, who play an important role in older driver assessment, do not routinely measure visual fields on their older patients. Additional research should be undertaken to identify better visual predictors of older driver risk that can be easily implemented at re-licensure.
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