Intraocular scattering as a predictor of driving performance in older adults with cataracts

Autoři: Sonia Ortiz-Peregrina aff001;  Carolina Ortiz aff001;  Carlos Salas aff001;  Miriam Casares-López aff001;  Margarita Soler aff001;  Rosario G. Anera aff001
Působiště autorů: Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Spain aff001
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article


Cataracts can limit a person’s ability to perform vision-dependent tasks safely, affecting the quality of life of older people. This study examines the relationship between visual function and driving, by studying which visual parameters might be important for predicting driving performance in older drivers with and without cataracts, ascertaining whether the objective measurement of intraocular scattering should be considered in assessment procedures for older drivers. This cross-sectional study involved a total of 20 older drivers (10 patients with bilateral cataracts and 10 control subjects). All participants were examined for visual acuity, contrast sensitivity, visual discrimination capacity, and intraocular scattering. Driving performance was also tested using a driving simulator. To study the relationship between visual parameters and driving performance, a correlation analysis and regression model were used. Drivers with cataracts showed a significantly impaired (p<0.05) visual function, with an Objective Scattering Index (OSI) 3.5 times greater than the control group. Driving performance was also significantly worse (p<0.05) in drivers with cataracts, reflected by a notable deterioration in lane keeping. The correlation analysis showed significant associations between driving performance and all the visual parameters studied. Finally, the regression model revealed that the OSI was the best predictor of driving performance, accounting for 51.3% of its variance. Visual function and driving performance are markedly deteriorated when cataracts are present. Our results demonstrate that the objective scattering index (OSI) has a high predictive power when it comes to simulated driving performance in older drivers, both with and without cataracts, suggesting that scatter measurements could be important in helping better understand visual limitations in older drivers.

Klíčová slova:

Aging – Cataract surgery – Cataracts – Eyes – Roads – Vision – Visual acuity – Visual impairments


1. Cohen JE. Human Population: The Next Half Century. Science 2003; 302: 1172–75. doi: 10.1126/science.1088665 14615528

2. Rosenbloom S. Sustainability and automobility among the elderly: An international assessment. Transportation 2001; 28: 375–408.

3. Nischler C, Michael R, Wintersteller C, Marvan P, Emesz M, Van Rijn LJ, et al. Cataract and pseudophakia in elderly European drivers. Eur J Ophthalmol. 2010; 20: 892–901. doi: 10.1177/112067211002000513 20213613

4. Rubin GS, Adamsons IA, Stark WJ. Comparison of acuity, contrast sensitivity, and disability glare before and after cataract surgery. Arch Ophthalmol. 1993; 111: 56–61. doi: 10.1001/archopht.1993.01090010060027 8424725

5. Wood JM, Carberry TP. Bilateral cataract surgery and driving performance. Br J Ophthalmol. 2006; 90: 1277–80. doi: 10.1136/bjo.2006.096057 16825273

6. Owsley C, Stalvey B, Wells J, Sloane ME. Older drivers and cataract: driving habits and crash risk. J Gerontol A Biol Sci Med Sci. 1999; 54: M203–11. doi: 10.1093/gerona/54.4.m203 10219012

7. Mönestam E, Lundquist B, Wachtmeister L. Visual function and car driving: longitudinal results 5 years after cataract surgery in a population. Br J Ophthalmol. 2005; 89: 459–63. doi: 10.1136/bjo.2004.051151 15774924

8. de Waard PW, IJspeert JK, van der Berg TJ, de Jong PT. Intraocular light scattering in age-related cataracts. Inves. Ophth Vis Sci. 1992; 33: 618–25.

9. Martínez-Roda JA, Vilaseca M, Ondategui JC, Aguirre M, Pujol J. Effects of aging on optical quality and visual function. Clin Exp Optom. 2016; 99: 518–25. doi: 10.1111/cxo.12369 27452417

10. van Rijn LJ, Nischler C, Gamer D, Franssen L, de Wit G, Kaper R, et al. Measurement of stray light and glare: Comparison of Nyktotest, Mesotest, stray light meter, and computer implemented stray light meter. Br J Ophthalmol. 2005; 89: 345–51. doi: 10.1136/bjo.2004.044990 15722317

11. van den Berg TJTP, van Rijn LJ, Kaper-Bongers R, Vonhoff HJ, Völker-Dieben G, Grabner G, et al. Disability glare in the aging eye. Assessment and impact on driving. J Optom. 2009; 2:112–18. 10.3921/joptom.2009.112

12. Ortiz C, Castro JJ, Alarcón A, Soler M, Anera RG. Quantifying age-related differences in visual-discrimination capacity: Drivers with and without visual impairment. Appl Ergon. 2013; 44: 523–31. doi: 10.1016/j.apergo.2012.11.006 23219003

13. Wood J, Carberry T. Older drivers and cataracts: measures of driving performance before and after cataract surgery. Transp Res Rec J Transp Res Board. 2004; 1865: 7–13. 10.3141/1865-02

14. van Rijn LJ, Nischler C, Michael R, Heine C, Coeckelbergh T, Wilhelm H, et al. Prevalence of impairment of visual function in European drivers. Acta Ophthalmol. 2011; 89: 124–31. doi: 10.1111/j.1755-3768.2009.01640.x 19832733

15. Owsley C, Stalvey BT, Wells J, Sloane ME, McGwin G Jr. Visual risk factors for crash involvement in older drivers with cataract. Arch Ophthalmol. 2001; 119: 881–87. doi: 10.1001/archopht.119.6.881 11405840

16. Pomerance GN, Evans DW. Test-retest reliability of the CSV-1000 contrast test and its relationship to glaucoma therapy. Invest Ophthalmol Vis Sci. 1994; 35: 3357–61. 8056510

17. Artal P, Benito A, Pérez GM, Alcón E, De Casas A, Pujol J, et al. An objective scatter index based on double-pass retinal images of a point source to classify cataracts. PLoS One 2011; 6: 1–7. 10.1371/journal.pone.0016823

18. Martínez-Roda JA, Vilaseca M, Ondategui JC, Giner A, Burgos FJ, Cardona G, et al. Optical quality and intraocular scattering in a healthy young population. Clin Exp Optom. 2011; 94: 223–29. doi: 10.1111/j.1444-0938.2010.00535.x 21083759

19. Fernández J, Rodríguez-Vallejo M, Martínez J, Tauste A, Piñero DP. From presbyopia to cataracts: a critical review on dysfunctional lens syndrome. J Ophthalmol. 2018; 4318405. 10.1155/2018/4318405

20. Chen F, Peng H, Ma X, Liang J, Hao W, Pan X. Examining the safety of trucks under crosswind at bridge-tunnel section: A driving simulator study. Tunn Undergr Sp Tech. 2019; 92: 103034.

21. Ortiz C, Ortiz-Peregrina S, Castro JJ, Casares-López M, Salas C. Driver distraction by smartphone use (WhatsApp) in different age groups. Accid Anal Prev. 2018; 117: 239–49. doi: 10.1016/j.aap.2018.04.018 29723735

22. Wood JM. Age and visual impairment decrease driving performance as measured on a closed-road circuit. Hum Factors 2002; 44: 482–94. doi: 10.1518/0018720024497664 12502165

23. Higgins KE, Wood JM. Predicting components of closed road driving performance from vision tests. Optom Vis Sci. 2005; 82: 647–56. doi: 10.1097/01.opx.0000174725.32907.86 16127329

24. Bal T, Coeckelbergh T, Van Looveren J, Rozema JJ, Tassignon MJ. Influence of cataract morphology on straylight and contrast sensitivity and its relevance to fitness to drive. Ophthalmologica 2011; 225: 105–11. doi: 10.1159/000317076 20881445

25. Preusser DF, Williams AF, Ferguson SA, Ulmer RG, Weinstein HB. Fatal crash risk for older drivers at intersections. Accid Anal Prev. 1998; 30: 151–59. doi: 10.1016/s0001-4575(97)00090-0 9450119

26. Wu G, Chen F, Pan X, Xu M, Zhu X. Using the visual intervention influence of pavement markings for rutting mitigation-part I: preliminary experiments and field tests. Int J Pavement Eng. 2019; 20: 734–746.

27. Zhu X, Dai Z, Chen F, Pan X, Xu M. Using the visual intervention influence of pavement marking for rutting mitigation II: visual intervention timing based on the finite element simulation. Int J Pavement Eng. 2019; 20: 573–584.

28. Wood JM, Troutbeck R. Effect of visual impairment on driving. Hum Factors 1994; 36: 476–87. doi: 10.1177/001872089403600305 7989052

29. Hills BL, Burg A. A reanalysis of California driver vision data: general findings (Report No. LR 768). Crowthorne, Berkshire, England: Transport and Road Research Laboratories 1977.

30. Owsley C, McGwin G. Vision and driving. Vision Res. 2010; 50: 2348–61. doi: 10.1016/j.visres.2010.05.021 20580907

31. Wood JM, Owens DA. Standard measures of visual acuity do not predict drivers’ recognition performance under day or night conditions. Optom Vis Sci. 2005; 82: 698–705. doi: 10.1097/01.opx.0000175562.27101.51 16127335

32. Babizhayev MA, Minasyan H, Richer SP. Cataract halos: A driving hazard in aging populations. Implication of the Halometer DG test for assessment of intraocular light scatter. Appl Ergon. 2009; 40: 545–53. doi: 10.1016/j.apergo.2007.09.003 18814857

33. Kimlin JA, Black AA, Wood JM. Nighttime driving in older adults: effects of glare and association with mesopic visual function. Invest Ophthalmol Vis Sci. 2017; 58: 2796–2803. doi: 10.1016/j.apergo.2007.09.003 28564700

34. van den Berg TJTP. The (lack of) relation between straylight and visual acuity. Two domains of the point-spread-function. Ophthalmic Physiol Opt. 2017; 37: 333–41. doi: 10.1111/opo.12368 28271538

35. Elliott DB, Ping S. Visual acuity versus letter contrast sensitivity in early cataract. Vision Res. 1998; 38: 2047–2052. doi: 10.1016/s0042-6989(97)00382-9 9797950

36. Castro JJ, Jiménez JR, Ortiz C, Alarcón A, Anera RG. New testing software for quantifying discrimination capacity in subjects with ocular pathologies. J Biomed Opt. 2011; 16: 015001. doi: 10.1117/1.3526702 21280903

37. Galliot F, Patel SR, Cochener B. Objective scatter index: working toward a new quantification of cataract? J Refract Surg. 2016; 32: 96–102. doi: 10.3928/1081597X-20151222-02 26856426

38. Martínez-Roda JA, Vilaseca M, Ondategui JC, Almudí L, Assad M, Mateos-Pena L, et al. Double-pass technique and compensation-comparison method in eyes with cataract. J Cataract Refract Surg. 2016; 42: 1461–69. doi: 10.1016/j.jcrs.2016.08.015 27839601

39. Hwang JS, Lee YP, Bae SH, Kim HK, Yi K, Shin YJ. Utility of the optical quality analysis system for decision- making in cataract surgery. BMC Ophthalmol. 2018; 18: 231. doi: 10.1186/s12886-018-0904-1 30176839

40. Ball K, Owsley C, Sloane ME, Roenker DL, Bruni JR. Visual attention problems as a predictor of vehicle crashes in older drivers. Invest Ophth Vis Sci. 1993; 34: 3110-

41. Bédard MB, Parkkari M, Weaver B, Riendeau J, Dahlquist M. Assessment of driving performance using a simulator protocol: validity and reproducibility. Am J Occup Ther. 2010; 64: 336–40. doi: 10.5014/ajot.64.2.336 20437921

42. Laitinen A, Laatikainen L, Härkänen T, Koskinen S, Reunanen A, Aromaa A. Prevalence of major eye diseases and causes of visual impairment in the adult Finnish population: a nationwide population-based survey. Acta Ophthalmol. 2010; 88: 463–71. doi: 10.1111/j.1755-3768.2009.01566.x 19878108

43. Fraser ML, Meuleners LB, Ng JQ, Morlet N. Driver self-regulation and depressive symptoms in cataract patients awaiting surgery: a cross-sectional study. BMC Ophthalmol. 2013; 13. doi: 10.1186/1471-2415-13-45

44. Freeman EE, Muñoz B, Turano KA, West SK. Measures of visual function and their association with driving modification in older drivers. Invest Ophthalmol Vis Sci. 2006; 47: 514–20. doi: 10.1167/iovs.05-0934 16431944

45. Keay L, Palagyi A, Do V, White A, Lamoureux E, Ivers RQ, et al. Vision and driving status of older Australians with cataract: an investigation of public hospital waiting lists. Clin Exp Optom. 2016; 99: 449–55. doi: 10.1111/cxo.12414 27452648

46. Brooks JO, Goodenough RR, Matthew CC, Nathan KD, Alley RL, Koon BL, et al. Simulator sickness during driving simulation studies. Accid Anal Prev. 2010; 42: 788–96. doi: 10.1016/j.aap.2009.04.013 20380904

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