Depending on where you live, driving can be a critical part of living independently. Without the ability to get around at will, mental health and quality of life can suffer. Yet, driving with glaucoma can become dangerous as the disease advances over time. Learn how glaucoma affects driving and what patients and providers can do to protect public safety on the roadways.*

Why driving with glaucoma can be dangerous

According to Optometry Times, people with glaucoma get into motor vehicle accidents at a much higher rate than people with normal vision, and the rate of accidents increases with disease severity. 

Tufts University glaucoma services director and ophthalmology professor Sarwat Salim, M.D., FACS says there are multiple ways glaucoma can affect driving performance, including:

• Difficulty staying in one lane
• Missing critical details when scanning the surroundings
• Controlling the vehicle’s speed

Peripheral (side) vision deteriorates over time in glaucoma. Salim says that people with glaucoma, especially in both eyes, feel they have a harder time driving than people with healthy eyes. Other people are overly cautious and stop driving prematurely. 

It’s important for glaucoma patients and their doctors to have open conversations about driving and not attempt to hide or deny visual issues. Loss of peripheral vision, even with intact central vision, can not only endanger patients behind the wheel but also endanger other drivers and passengers on the road.

How healthcare providers can do a better job

According to Salim, clinicians need to do a better job at assessing driving ability in glaucoma patients and focus on maintaining and improving functionality. Continuing to drive, for instance, may help some patients adhere to therapy.

She says physicians should be proactive in finding out whether or not patients:

• Are currently driving, 
• Are still fit to drive, and
• Know their state’s driving requirements. 

They should educate and guide patients about their driving fitness, and refer them to visual rehabilitation if necessary. Personal and public safety should be emphasized, she says. Patients should know that, while it may be legal for them to drive, it may not be safe.

Signs of unsafe driving

The American Academy of Ophthalmology (AAO) outlines red flags for driving safety that everyone (regardless of age) should be aware of:

• Noticeable vision loss or blurry vision
• A dark spot in your peripheral or central vision
• Difficulty reading street signs or seeing pedestrians
• Glare or halos around oncoming headlights or streetlights

AAO advises making an appointment with an ophthalmologist if you experience any of these signs.

Even mild glaucoma can impair driving

In a large study, two groups of drivers with and without glaucoma were evaluated by experts who were unaware of which participants had glaucoma. The data showed that those with mild-to-moderate glaucoma had worse driving performance than those with normal vision. Specifically:

• Drivers with glaucoma were more likely to have problems maintaining lane position and seeing their surroundings, especially at busy intersections, and
• They were also more apt to make critical errors requiring driving instructor intervention.

How’s your vision?

Visual acuity requirements for drivers vary among U.S. states, with some stricter than others. Requirements generally range from 20/40 to 20/100 visual acuity and a 55- to 150-degree visual field. That said, about 2% to 3% of drivers don’t meet the minimum legal vision requirements and would fail a standard vision test. Salim said patients with poor vision can be afraid to lose their driver’s license and continue driving.

Ask your doctor about ways to stay safe on the road. Helpful resources, including driver rehabilitation for people with disabilities, are also available.

*Charters, L. (2023, April 13). Driving with glaucoma: Steering clear of vision issues. Optometry Times. https://www.optometrytimes.com/view/driving-with-glaucoma-steering-clear-of-vision-issues