Obstacle avoidance, visual detection performance, and eye-scanning behavior of glaucoma patients in a driving simulator: a preliminary study

PLoS One. 2013 Oct 16;8(10):e77294. doi: 10.1371/journal.pone.0077294. eCollection 2013.


The objective of this study was to evaluate differences in driving performance, visual detection performance, and eye-scanning behavior between glaucoma patients and control participants without glaucoma. Glaucoma patients (n = 23) and control participants (n = 12) completed four 5-min driving sessions in a simulator. The participants were instructed to maintain the car in the right lane of a two-lane highway while their speed was automatically maintained at 100 km/h. Additional tasks per session were: Session 1: none, Session 2: verbalization of projected letters, Session 3: avoidance of static obstacles, and Session 4: combined letter verbalization and avoidance of static obstacles. Eye-scanning behavior was recorded with an eye-tracker. Results showed no statistically significant differences between patients and control participants for lane keeping, obstacle avoidance, and eye-scanning behavior. Steering activity, number of missed letters, and letter reaction time were significantly higher for glaucoma patients than for control participants. In conclusion, glaucoma patients were able to avoid objects and maintain a nominal lane keeping performance, but applied more steering input than control participants, and were more likely than control participants to miss peripherally projected stimuli. The eye-tracking results suggest that glaucoma patients did not use extra visual search to compensate for their visual field loss. Limitations of the study, such as small sample size, are discussed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Automobile Driving*
  • Case-Control Studies
  • Computer Simulation
  • Female
  • Fixation, Ocular
  • Glaucoma / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Psychomotor Performance*
  • Reaction Time
  • Surveys and Questionnaires
  • Visual Fields*

Grant support

The research of Joost de Winter was supported by the Dutch Technology Foundation (Stichting voor de Technische Wetenschappen), the Applied Science Division of the Netherlands Organisation for Scientific Research (Nederlandse Organisatie voor Wetenschappelijk Onderzoek), and the Technology Program of the Ministry of Economic Affairs. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.