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Letters
June 2013

Central Visual Field Loss and Driving—Reply

Author Affiliations

Author Affiliations: Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston.

JAMA Ophthalmol. 2013;131(6):819-821. doi:10.1001/jamaophthalmol.2013.4259

In reply

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.14 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.58 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.

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