Uncertainty of glaucoma patient accidents easier to discern with new tests

Take-home message: New strategies for assessment of functional impairment will help clinicians and patients better understand how eye diseases affect driving and other activities of daily living.

 

By Nancy Groves; Reviewed by Peter N. Rosen, MD

San Diego-New tests to assess visual performance-more closely resembling real-world conditions-may help clinicians discern the risk of motor vehicle accidents and falls in individuals with glaucoma and other eye diseases, said Peter N. Rosen, MD, associate clinical professor, Shiley Eye Institute, University of California, San Diego (UCSD).

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Conventional testing methods, such as Snellen acuity and standard automated perimetry, are poorly correlated with activities of daily living, driver safety, and risk of falls-partly because of their lack of secondary task demands, such as divided attention and visual processing speed.

Also, these tests are usually performed under ideal conditions. Additionally, the information derived from these tests may not always provide sufficient insight into their impact on task performance and vision-related quality of life.

“In ophthalmology and other fields of medicine, we often treat arbitrarily defined ‘abnormal’ test results (e.g., visual acuity) whose correlation with impaired task performance and quality of life is poorly understood,” Dr. Rosen said. “Our lab is trying to improve our understanding of the relationship between visual performance, task performance, and quality of life since it is not always clear when treatment or counseling is required that makes a difference in the last two.”

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Processing speed

One of the newest methodologies used in the Visual Performance Lab at UCSD is the iPad-based PERformance-CEntered Portable Test (PERCEPT). The PERCEPT processing speed test is designed to improve the sensitivity of detecting visual impairment in the macula and reflect real-world conditions of rapidly changing scene, complexity, and low contrast, Dr. Rosen noted.

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