Author Affiliations: Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston.
Desapriya and colleagues commented on our use of simulation in evaluating detection performance of drivers with CFL. Although driving assessments using open-road courses have high face validity, such studies are limited by the inability to control whether, when, and where hazards appear.1- 4 By comparison, a high-fidelity driving simulator, such as the one used in our study,5 provides a safe, controlled environment in which to conduct much-needed studies to evaluate the effects of different types and levels of vision impairment on driving performance.5- 8 Using a driving simulator, we have been able to repeatedly evaluate detection of potential pedestrian hazards under exactly the same conditions for all participants in a manner that is impossible in an on-road study1 (even using a closed-road course). In the prior on-road study of drivers with “mild” central field loss (CFL)3 that Desapriya and colleagues noted, there were only 2 stunt actor appearances per driver compared with 104 pedestrian appearances per participant in our driving simulator study.
Bronstad PM, Bowers AR, Albu A, Goldstein RB, Peli E. Central Visual Field Loss and Driving—Reply. JAMA Ophthalmol. 2013;131(6):819-821. doi:10.1001/jamaophthalmol.2013.4259