Impact of vision disorders and vision impairment on motor vehicle crash risk and on-road driving performance: A systematic review
DOI: 10.1111/aos.14908
archive: archived pipeline: cataloged verified
Summary
PRISMA-compliant systematic review (PROSPERO CRD42020180135) of the impact of vision disorders and visual impairment on motor-vehicle-crash (MVC) risk and on-road driving performance, drawing on seven electronic databases. Forty-eight studies met inclusion criteria: 36 on MVC risk, 9 on on-road performance, and 3 on both. Fewer than half were rated 'good' quality. Findings were often conflicting; the strongest signal was increased MVC risk associated with binocular visual-field impairment. Evidence on cataract, glaucoma, age-related macular degeneration, and homonymous field loss was mixed, and mild visual-acuity impairment showed no increased MVC risk. The review highlights the need for better-designed studies to inform fitness-to-drive policy.
Key finding
Across 48 included studies, only binocular visual-field impairment showed consistent evidence for elevated motor-vehicle-crash risk; evidence for cataract, glaucoma, AMD, and homonymous field loss was mixed, and mild visual-acuity impairment was not associated with increased risk.
Methodology
Systematic review following PRISMA, prospectively registered in PROSPERO. Searched seven databases (Cochrane, Ovid MEDLINE, PsycINFO, Embase, CINAHL PLUS, and others) with predefined inclusion criteria; study quality rated using a standard tool.
Sample size: 48 included studies (36 MVC risk, 9 on-road performance, 3 both).
Quality score: 5 / 5