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Policy recommendations regarding driver impairment and methods of intervention The Immortal Vision workshop

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Policy recommendations regarding driver impairment and methods of intervention The Immortal Vision workshop

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    1. Policy recommendations regarding driver impairment and methods of intervention The Immortal Vision workshop Gunnar Deinboll Jenssen SINTEF Roads and Transport Norway

    2. Vision and perceptual deficiencies as a risk factor in traffic safety

    3. Vision and perceptual deficiencies as a risk factor in traffic safety What is the link between accidents and driver vision, the assessment of visual driving ability and licensing? Can we enhance traffic safety by measuring visual function of drivers and exclude those with impaired visual function? What do we need to know? Is there a relation between vision impairment and unsafe driving? What is the criterion validity? What is the prevalence of impairments? Do we have an adequate test?

    4. What determines driving behaviour? Cultural

    6. Vision and perceptual deficiencies as a risk factor in traffic safety Visual acuity Visual field defects Cataract Glaucoma Corneal disease Retinal degeneration Amblyopia Contrast sensitivity Glare Useful field of view Stereopsis (depth perception) Eye movement disorders Myopia Hypermetropia Presbyopia Astigmatism Refractive disorders Reduced night-time vision Color vision Motion detection Post-cataract surgery: Without lens implant Post-cataract surgery: With lens implant

    7. Vision workshop Purpose Broad introduction to state-of- the-art related to visual and perceptual problems Focus on new research results for selected topics Provide updated evidence of accident risk associated with visual defects. Discuss effectiveness of screening devices to test for visual defects. Support future development of policy governing driver impairment with visual defects.

    8. Vision Workshop 1. Background and EU policies 2. Vision problems that are relevant for traffic safety 3. Methods to deal with these problems 4. How to deal with these problems in driver licensing

    9. Dr. L.J. Van Rijn, Department of Ophthalmology at the Vrije University Medical Centre: ”Eu policies : Assessment of vision impairment and driver licensing” Senior research Scientist Truls Vaa, TŘI: “Relative accident risks associated with vision impairments and other medical conditions: Results from meta-analysis” Senior research Scientist Gunnar D. Jenssen, SINTEF: “Visual field defects and accident risk, a retrospective study”

    10. Vision workshop Dr. L.J. Van Rijn, Department of Ophthalmology at the Vrije University Medical Centre: “Methods for measuring glare and straylight” Prof. Dr. Aart Kooijman, Laboratory of experimental Opthalmology, Groningen: “Training of compensatory viewing strategies in subjects with visual field defects”

    11. Vision workshop Senior Medical Adviser Bo Bjerre, Swedish Public Roads Administration: “Swedish policy in driver licensing for visually impaired” Chief Medical Officer Hĺvard Arnljot, Region Hospital of Sollefteĺ: “A cross cultural comparison of driver licensing routines for visually impaired

    14. Meta Analysis Preliminary results Visual field defects Glare Reduced night time vision

    18. Insurance accidents

    19. Patients with visual field defects may consciously or unconsciously compensate with: Active search strategies and recheck in "blind" area before driving on. Use of mirrors Increased attention and situational awareness Observational skills (situation awareness and attention) Perceptual skills (detection of stimuli), Decision making skills (making and executing correct judgements) Vehicle handling (navigating chosen course and adapting vehicle position) Distinctness (communicating own driving behaviour to other vehicles) Risk perception (ability to perceive, evaluate and handle risk) Empathic reasoning (ability to take other drivers perspective in a situation)

    20. Methods of intervention Conventional straylight meter New straylight meter Nyktotest Mesotest.

    21. Methods of intervention Of the glare/straylight tests that were investigated, the New straylight meter was superior. Repeatability, discriminative ability, resistance to fraud and added value were all on the level that should be required from a test. Recommended that in studies into the relation between glare/straylight and traffic safety, the straylight meter should be included as a measurement device. Further studies, focussing on validity and prevalence of impairments, should reveal whether implementation of this test for the assessment of drivers is warranted.

    22. Methods of intervention “Training of compensatory viewing strategies in subjects with visual field defects” A considerable percentage of the subjects with visual field defects demonstrated to drive safely, even before the training. After training of compensatory viewing behavior (especially while driving), driving performance of the subjects improved. For subjects with homonymous hemianopsia, the results demonstrate improvements of all insufficient driving tasks. Therefore, the study concludes that: Integrating saccadic compensation training can improve scanning behavior in homonymous hemianopsia. Improved scanning can improve neuropsychological test performance. Integrating saccadic compensation training can improve practical driving tasks. Finally, the study suggests that the training schedule should be individualized.

    25. Conclusions Night vision and glare problems increase the accident risk. With more elderly drivers it is important to verify if this is a problem or not. A new test for measuring glare straylight is promising, but it needs to be further developed before it can become common practice.

    26. Conclusions Visual field defects and the fact that many are not aware of their defect increase the accident risk. Some drivers with visual field defects may drive adequately because they compensate for their impairment Compensation techniques can be trained Strict regulation, but more drivers should be allowed to prove they can compensate adequately for the impairment On road and simulator tests can test compensation for visual field defects

    27. Conclusions What is the cost/benefit concerning various driver licensing requirements related to vision. Prevalence, relative risk, cost for society. Monitor new surgical methods and driver support systems The rules for vision-related driving licensing requirements need to be harmonised

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