Purpose: Cataract surgery and intraocular lens implantation may alter peripheral optics due to changes in peripheral refractive error. Driving is a highly demanding visual task that could be affected by these changes. Thus, this study aimed to investigate the influence of additional peripheral refractive errors on driving performance.
Methods: Thirty-one young drivers were included in the study. Driving performance was assessed by means of a driving simulator. Participants were induced different additional peripheral refractive errors using ophthalmic lenses that allowed normal central binocular vision. Thus, they drove under 7 experimental conditions: baseline session (0D), with spheres of +/- 2D and +/- 4D (hyperopic and myopic defocus), and with cylinders of +2D and +4D oriented at 180° (astigmatism). While driving, participants had to interact with a touch screen at 40° to perform two tasks: searching for traffic signs through a document and typing an address on Google Maps. Peripheral visual acuity and peripheral contrast sensitivity were measured at the same eccentricity.
Results: Driving performance was significantly impaired by the addition of peripheral refractive myopic defocus of 4D and 4D of astigmatism. One of the most affected aspects was the ability to maintain the vehicle’s position within the lane. When interacting with the Google Maps task, the impairment in driving performance was greater than for the route in general (all tasks). Worse driving performance was significantly correlated with worse peripheral contrast sensitivity, but also with worse peripheral visual acuity when participants were performing Google Maps tasks.
Conclusions: Driving performance is affected by peripheral refractive changes when performing secondary visual-manual tasks. The impairment is associated with peripheral contrast sensitivity and visual acuity. These results have implications for patients undergoing procedures such as cataract surgery given that peripheral optical quality of eyes implanted with IOL will be modified.
