Association of Cataract Surgery With Traffic Crashes

Injury Prevention, 2008

Objectives: To assess the effects of cataract surgery in improving vision and driving performance while reducing driving-related difficulties. ... Data sources: Twelve electronic databases were searched from the date of inception of each database to May 2007. Other sources of potentially relevant information were also identified and examined. ... Review methods: Eligible study designs included randomized controlled trials (RCT), non-RCT, quasi-experimental, case-control, controlled-before-and-after, and cohort studies that examined driving-related indicators in ...

Optometry and Vision Science, 2008

Accident Analysis & Prevention, 2013

Older adults who undergo cataract extraction have roughly half the rate of motor vehicle collision (MVC) involvement per mile driven compared to cataract patients who do not elect cataract surgery. Currently in the U.S., most insurers do not allow payment for cataract surgery based upon the findings of a vision exam unless accompanied by an individual's complaint of visual difficulties that seriously interfere with driving or other daily activities and individuals themselves may be slow or reluctant to complain and seek relief. As a consequence, surgery tends to occur after significant vision problems have emerged. We hypothesize that a proactive policy encouraging cataract surgery earlier for a lesser level of complaint would significantly reduce MVCs among older drivers. We used a Monte Carlo model to simulate the MVC experience of the U.S. population from age 60 to 89 under alternative protocols for the timing of cataract surgery which we call "Current Practice" (CP) and "Earlier Surgery" (ES). Our base model finds, from a societal perspective with undiscounted 2010 dollars, that switching to ES from CP reduces by about 21% the average number of MVCs, fatalities, and MVC cost per person. The net effect on total cost -all MVC costs plus cataract surgery expenditures --is a reduction of about 16%. Quality Adjusted Life Years would increase by about 5%. From the perspective of payers for healthcare, the switch would increase cataract surgery expenditure for ages 65+ by about 8% and for ages 60 to 64 by about 47% but these expenditures are substantially offset after age 65 by reductions in the medical and emergency services component of MVC cost. Similar results occur with discounting at 3% and with various sensitivity analyses. We conclude that a policy of ES would significantly reduce MVCs and their associated consequences.

PloS one, 2015

To evaluate the ability of longitudinal Useful Field of View (UFOV) and simulated driving measurements to predict future occurrence of motor vehicle collision (MVC) in drivers with glaucoma. Prospective observational cohort study. 117 drivers with glaucoma followed for an average of 2.1 ± 0.5 years. All subjects had standard automated perimetry (SAP), UFOV, driving simulator, and cognitive assessment obtained at baseline and every 6 months during follow-up. The driving simulator evaluated reaction times to high and low contrast peripheral divided attention stimuli presented while negotiating a winding country road, with central driving task performance assessed as "curve coherence". Drivers with MVC during follow-up were identified from Department of Motor Vehicle records. Survival models were used to evaluate the ability of driving simulator and UFOV to predict MVC over time, adjusting for potential confounding factors. Mean age at baseline was 64.5 ± 12.6 years. 11 of 11...

IP Innovative Publication Pvt Ltd, 2019

ocular injuries in RTA constitute a major but preventable cause of visual morbidity worldwide and so it is of public health importance. Aim of study was to assess the visual outcomes in patients attending tertiary care hospital with ocular injuries following RTA and compare various associated risk factors. Materials and Methods: A prospective study was done with 104 cases of ocular injuries following RTA in GSL Medical College and Hospital to find out the visual outcome and compare various risk factors. Detailed History and clinical evaluation was done with follow up at 1st and 3rd week. Results: Maximum cases were seen in the age group of 30-50yrs, more in males (82.0%), with 67% in two wheelers. Out of the 104 cases, 67% occurred at night, 50% was under the influence of alcohol. Out of which 61% of lid injuries followed by subconjunctival haemorrhage have good prognosis. 14% cases reported with severe ocular morbidity like open globe injuries with guarded prognosis. Conclusions: Younger age group was mostly affected with male preponderance, alcohol and two wheelers being quite important risk factors. Early treatment of ocular injuries and use of protective wear result in better visual outcomes. Keywords: Alcohol influence, Ocular injury, Road traffic accidents, Subconjunctival haemorrhage, Two-wheeler.

Transportation Research Part F: Traffic Psychology and Behaviour, 2018

BMJ Open, 2020

Introduction Driving is one of the main modes of transport with safe driving requiring a combination of visual, cognitive and physical skills. With population ageing, the number of people living with vision impairment is set to increase in the decades ahead. Vision impairment may negatively impact an individual’s ability to safely drive. The association between vision impairment and motor vehicle crash involvement or driving participation has yet to be systematically investigated. Further, the evidence for the effectiveness of vision-related interventions aimed at decreasing crashes and driving errors has not been synthesised. Methods and analysis A search will be conducted for relevant studies on Medline (Ovid), EMBASE and Global Health from their inception to March 2020 without date or geographical restrictions. Two investigators will independently screen abstracts and full texts using Covidence software with conflicts resolved by a third investigator. Data extraction will be cond...

Eye, 2019

Objectives To evaluate risk factors associated with eye injuries related to motor vehicle accidents (MVA) using a multicentre national database from the US emergency departments. Patients and methods A post hoc analysis from the Nationwide Emergency Department Sample database (2006-2013) was performed. Patients presenting to the emergency department (ED) with MVA-related trauma were included. We then evaluated patient-and centre-level risk factors associated with the presence of ocular trauma using a multivariable logistic regression model. Results A total of 2,745,152 patients from 2080 ED were identified for inclusion. Of these, 31,493 patients (1.14%) were associated with ocular trauma. The most common ocular injuries reported in our study were injury to ocular adnexa, orbital fractures, subconjunctival haemorrhage, foreign body on eye, and open wound of the eyeball. In univariate analysis, the other patient factors associated with ocular trauma included male gender, >1 chronic condition, admission during weekend, >1 bodily injury, higher injury severity score (ISS), presence of skull fractures and other bodily fractures, seizures, and initiation of mechanical ventilation after MVA. The hospital characteristics associated with highest incidence of ocular trauma included ED visit to a level I trauma centre and metropolitan teaching hospital. The independent factors associated with ocular trauma included younger age groups, male gender, weekend injury, presence of chronic conditions, >1 bodily injury, higher ISS, presence of skull fractures, ED admission to level-1 trauma centre, and ED admission to a teaching hospital. Conclusions This multicentre study establishes that both patient-and centre-level factors are associated with MVA-related eye injuries.

Journal of Optometry, 2021

The presence of cataract causes reduction in visual acuity (VA) and contrast sensitivity (CS) and thus can affect individual's daily activities. The aim of this study was to investigate self-reported driving difficulty in patients with bilateral cataract. Methods: A total of 99 participants aged 50 and above, with bilateral cataract, who possessed a valid driving license and drove regularly were chosen for this cross-sectional study that looked into their visual functions (VA and CS) and driving difficulty using the self-reported Driving Difficulty Questionnaire. Results: The mean age of the participants was 65.04 §7.22 years old. Results showed that the mean composite driving difficulty score was 83.18 §11.74 and most of the participants were having difficulty for driving in the rain (73.7%) and at night (85.9%). Furthermore, the study found that there was a significant correlation between driving difficulty score and CS (rs = 0.40, p = 0.03). However, there was no significant correlation between driving difficulty score and VA (rs =-0.14, p = 0.17). A linear regression was calculated to predict driving difficulty score based on binocular CS and a significant regression equation was found (F (1,28) = 8.115, p = 0.008) with R 2 of 0.225. Drivers with bilateral cataract will most likely experience some forms of difficulty, especially when driving under low contrast conditions.

IP International Journal of Ocular Oncology and Oculoplasty, 2021

To study the epidemiology, clinico-radiological pattern and visual outcome in patients having ocular injuries following road traffic accident and also compare various risk factors associated with it. Materials and Methods: A prospective, hospital based, observational study was performed at a teaching hospital of North India. Various parameters including demographics, time, place and session of injury, type of road, vehicle & collision, type of injury, severity & location of injury, radiological findings and initial & final visual acuity were analysed. The association between ocular trauma and characteristics of the accident were evaluated. Results: Out of 402 patients of ocular trauma, 101 eyes of 95(23.63%) patients had injuries due to road traffic accidents. It was observed that males were affected predominantly (88.40%).The ratio between men and women was 7.6:1, age ranged from 1 year to 67 years. The most vulnerable age group was 21-30 year (25.30%) followed by 31-40 year (24.20%) and 11-20 year (21.10%).Maximum injury victims were illiterate (33.68%) or had primary education only (29.47%). The majority were married (68.42%) and belonged to rural background (42.10%). Most of the road traffic accidents occur in summer season (47.37%). Majority of the victims sustained injury in the afternoon between 12.00-17.59 hrs (29.47%) and in evening between 18.00-23.59 hrs (27.33%). 57.89 % victims were not using any protective gear at the time of injury. Driving under influence of alcohol (42.11%) and sleepiness or drowsiness of victims (21.05%) were found to be an important risk factor in ocular injury. 43.61% of the accidents took place at highway. Two-wheeler occupants (30.53%) were more prone to ocular trauma than pedestrians (13.68%), three-wheelers occupants (5.26%) and car occupants (21.05%). However 29.47% victims were travelling in heavy vehicles like bus/ truck. The most common mode of road accident was collision with other stationary objects like a tree, pole, milepost and other vehicle (51.58%) followed by swerved / skidded vehicle (26.32%) and run in the ditch (13.68%). The commonest mode of injury was frontal impact or head-on collision (37.89%) followed by sideways impact (26.32%) and hit by projectile object (6.32%). However, in 29.47% cases the mode of injury was indeterminate. Conclusion: Road traffic accidents can cause severe ocular trauma. Victims are usually adult males of productive age group. Two wheeler occupants, driving under influence of alcohol and non-use of protective gear were found to be major risk factors. Frontal impacts posed the greatest risk of orbito-facial trauma. Open globe injury and multiple orbital wall fracture usually associated with poor prognosis. Use of helmet and seatbelt may reduce the frontal impact and hence vision threatening ocular trauma.

Clinical & experimental optometry, 2016

Although cataract surgery can restore sight, lengthy waiting times are common in public hospitals in Australia. We investigated the driving status of older people during their surgical waiting period. Baseline, cross-sectional data from two prospective cohort studies of patients aged 50 years and older on Australian public hospital cataract surgery waiting lists were analysed. Participants underwent assessment of vision and completed the Driving Habits Questionnaire. The vision status was compared between current drivers and former drivers. Participants (n = 442) were on average 73 ± 8 years of age and approximately half were women (229/442, 52 per cent). Habitual vision was 6/12(+2) on average (0.26 ± 0.21 logMAR). There were 263 (60 per cent) current drivers, 110 (25 per cent) former drivers and 69 participants (16 per cent) who had never driven. Among the current drivers, 82/263 (31 per cent) failed visual acuity requirements for an unconditional drivers' license (6/12 acuity...

Accident Analysis & Prevention, 1996

In this research we studied the association between commercial motor vehicle drivers' medical conditions and crash severity. Some aspects of medical condition were considered. To our knowledge, no study has ever .isolated this association. The severity of a crash was measured by the total number of victims (injured and dead). We estimated nonlinear regression models (specifically, Poisson and negative binomial) which incorporated, simultaneously, information on drivers' characteristics, crash circumstances and health status, in order to isolate the association between health status and crash severity. Our results show that crashes of truck drivers with binocular vision problems and bus drivers with hypertension are more severe than those of healthy drivers. No other medical condition considered in this study was significantly associated with crash severity. Many variables describing crash circumstances were also significant.

Western Journal of Emergency Medicine, 2014

Motor vehicle crashes (MVCs) are a leading cause of injury in the United States (U.S.). Detailed knowledge of MVC eye injuries presenting to U.S. emergency departments (ED) will aid clinicians in diagnosis and management. The objective of the study was to describe the incidence, risk factors, and characteristics of non-fatal motor vehicle crash-associated eye injuries presenting to U.S. EDs from 2001 to 2008. Methods: Retrospective cross-sectional study using the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) from 2001 to 2008 to assess the risk of presenting to an ED with a MVC-associated eye injury in relation to specific occupant characteristics, including age, gender, race/ethnicity, disposition, and occupant (driver/passenger) status. Results: From 2001 to 2008, an estimated 75,028 MVC-associated eye injuries presented to U.S. EDs. The annual rate of ED-treated eye injuries resulting from MVCs declined during this study period. Males accounted for 59.6% of eye injuries (95% confidence interval [CI] 56.2%-63.0%). Rates of eye injury were highest among 15-19 year olds (5.8/10,000 people; CI 4.3-6.0/10,000) and among African Americans (4.5/10,000 people; CI 2.0-7.1/10,000). Drivers of motor vehicles accounted for 62.2% (CI 58.3%-66.1%) of ED-treated MVC eye injuries when occupant status was known. Contusion/Abrasion was the most common diagnosis (61.5%; CI 56.5%-66.4%). Among licensed U.S. drivers, 16-24 year olds had the highest risk (3.7/10,000 licensed drivers; CI 2.6-4.8/10,000). Conclusion: This study reports a decline in the annual incidence of ED-treated MVC-associated eye injuries. The risk of MVC eye injury is greatest among males, 15 to 19 year olds and African Americans.

Background In traffic accidents, eye injuries occur as isolated or with polytrauma. They may involve just one eye, but simultaneous injuries to both eyes do happen occasionally. The aim of our paper was to reveal the risk factors, in an effort to reduce the number of such accidents and to prevent bilateral ocular damage. Methods All patients hospitalized at the Clinic of Eye Diseases, Clinical Center of Serbia, Belgrade, due to traffic accidents with bilateral eye injuries in a period of 9 years from the beginning of 2000 to the end of 2008 were analyzed. Results In this 9-year period, a total of 36 patients were hospitalized and treated for bilateral ocular injury (72 eyes). There were 23 males among them, the male-female ratio being 1.8:1. Mean age was 33.9 years. The occupations of injured persons were the following: the most common were workers—15, followed by clerks—seven, while less common were pupils, students, pensioners and housewives—three of each of them, and farmers—two. Front-seat passengers were the most common among the injured—20 (55.6%), then drivers—15 (41.7%), with only one passenger from the back seat on the right side (2.7%). As many as 33 (91.7%) of them failed to fasten their seat belts, while 18 (50.0%) were drunk. Penetrating bulbar injuries or eyeball ruptures were predominant—66.7%, while blunt injuries were found in only two (2.8%) eyes in one single person; but in 22 cases (30.5%) there was adnexal damage, too. M. Jovanovic (*) : P. Hentova-Sencanic : D. Vukovic : S. Glisic : M. Knezevic Clinic of Eye Diseases, Clinical Center of Serbia, 2, Pasterova Street, Belgrade 11000, Serbia e-mail: [email protected] Visual acuity at discharge and subsequent controls was as follows: amaurosis in 21 (29.2%), less than 0.3 in nine (5.6%), 0.4 and better in 42 (58.1%), and normal visual acuity of 1.0 in 28 patients (38.3%). Conclusion The major risk factors for getting bilateral eye injuries in traffic accidents proved to be: sitting in the front car seats, not fastening the seat belt and alcohol intoxication. Prevention of these risk factors would result in a decrease in such a large number of bilateral eye injuries.

Open Access Macedonian Journal of Medical Sciences

BACKGROUND: The mortality rate due to road traffic accidents (RTA) is significantly high in Saudi Arabia (SA) compared to other countries. The visual function which includes good visual acuity (VA) and binocular vision are very important factors that can contribute to the incidence of RTA. AIM: The aim of this study is to investigate the association between refractive errors (REs) and the RTA in SA. METHODS: A total of 354 participants (mean age 22.67 ± 3.22 years) were recruited randomly to participate in this study from the population of Qassim district. Data collected using the questionnaire included participants’ age, sex, and education level, ocular and medical history, driving history as well as history of RTA. Ocular health examination including VA, RE measurements, and binocular vision function vision was measured and analyzed. RESULTS: The results of this study show that 48.3% of drivers had some form of REs with 3.4% being visually impaired. 217 (61.3%) of participants hav...