Abstract
Purpose: To assess the effect of pupil dilation on vision and driving ability.
Methods: A series of tests on various parameters of visual function and driving simulator performance were performed on 12 healthy drivers, before and after pupil dilation using guttae tropicamide 1%. A driving simulator (Transport Research Laboratory) was used to measure reaction time (RT), speed maintenance and steering accuracy. Tests of basic visual function included high- and low- contrast visual acuity (HCVA and LCVA), Pelli-Robson contrast threshold (CT) and Goldmann perimetry (FIELDS). Useful Field of View (UFOV - a test of visual attention) was also undertaken. The mean differences in the pre- and post-dilatation measurements were tested for statistical significance at the 95% level using one-tail paired t-tests.
Results: Pupillary dilation resulted in a statistically significant deterioration in CT and HCVA only. Five of 12 drivers also exhibited deterioration in LCVA, CT and RT. Little evidence emerged for deterioration in FIELDS and UFOV. Also, 7 of 12 drivers appeared to adjust their driving behaviour by reducing their speed on the driving simulator, leading to improved steering accuracy.
Conclusions: Pupillary dilation may lead to a decrease in vision and daylight driving performance in young people. A larger study, including a broader spectrum of subjects, is warranted before guidelines can be recommended.
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References
Sivak M . The information that drivers use: is it indeed 90% visual? Perception 1996;25:1081–9.
Taylor JF . Vision and driving. Ophthalmic Physiol Opt 1987;7:187–9.
Munton G . Vision. In: Taylor JF, editor. Medical aspects of fitness to drive: a guide for medical practitioners. London: The Medical Commission on Accident Prevention, 1995:118–32.
Causes of blindness and partial sight in England and Wales 1990-1991. SMPS no. 57 London: HMSO, 1995.
Pollack AL, Brodie SE . Diagnostic yield of the routine dilated fundus examination. Ophthalmology 1998;105:382–6.
Nelson ME, Orton HP . Counteracting the effects of mydriatics: does it benefit the patient? Arch Ophthalmol 1987;105:486–9.
Montgomery DM, MacEwan CJ . Pupil dilatation with tropicamide: the effects on acuity, accommodation and refraction. Eye 1989;3:845–8.
Jude EB, Ryan B, O'Leary BM, Gibson JM, Dodson PM . Pupillary dilation and driving in diabetic patients. Diabetic Med 1998;15:143–7.
Pelli DG, Robson JG, Wilkins AJ . The design of a new letter chart for measuring contrast sensitivity. Clin Vis Sci 1988;2:187–99.
Elliot DB, Bullimore MA, Bailey IL . Improving the reliability of the Pelli-Robson contrast sensitivity test. Clin Vis Sci 1991;6:471–5.
Bailey IL, Lovie JE . New design principles for visual acuity letter charts. Am J Optom Physiol Opt 1976;53:740–5.
Bullimore MA, Bailey IL . Clinical grading: can we do better? In: Digest of topical meeting on noninvasive assessment of the visual system, vol. 3. Washington, DC: Optical Society of America, 1990:2–5.
Bailey IL, Bullimore MA, Raasch TVV, Taylor HR . Clinical grading and the effects of scaling. Invest Ophthalmol Vis Sci 1991;32:422–32.
Ball K, Owsley C, Sloane ME, Roenker DL, Bruni JR . Visual attention problems as a predictor of vehicle crashes in older drivers. Invest Ophthalmol Vis Sci 1993;34:3110–23.
Gilmartin B, Amer AC, Ingleby S . Reversal of tropicamide mydriasis with single instillations of pilocarpine can induce substantial pseudo-myopia in young adults. Ophthalmic Physiol Opt 1995;15:475–9.
Sachs L . Statische Methode: Plannung und Auswertung. 6th ed. Berlin: Springer, 1992:49.
Drasdo N, Haggerty CM . A comparison of British number plate and Snellen vision tests for car drivers. Ophthalmic Physiol Opt 1981;1:39–54.
Buckley DJ, Frucht-Pery J, Lin S, Brown SI, Feldman ST . The effect of pupillary size on contrast sensitivity function. Invest Ophthalmol Vis Sci 1990;30(Suppl):406.
Johnson CA, Keltner JL . Incidence of visual field loss in 20 000 eyes and its relationship to driving performance. Arch Ophthalmol 1983;101:371–5.
The highway code. London: HMSO, 1996.
O'Connor PS, Tredici TJ, Pickett J, Byrne B, Peters DR . Effects of routine pupillary dilation on functional daylight vision. Arch Ophthalmol 1988;106:1567–9.
Williamson TH, Strong NP, Sparrow J, Aggarwal RK, Harrad R . Contrast sensitivity and glare in cataract using the Pelli-Robson chart. Br J Ophthalmol 1992;76:719–22.
Watts P, O'Duffy D, Riddell C, McCleod S, Watson SL . Can I drive after those drops, doctor? Eye 1998;12:963–6.
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Funding: Supported by grants from the Research into Eye Disease Trust and Vauxhall Motors
Presented as a poster at the Annual Congress of the Royal College of Ophthalmologists, 1999
Conflict of interest: None
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Potamitis, T., Slade, S., Fitt, A. et al. The effect of pupil dilation with tropicamide on vision and driving simulator performance. Eye 14, 302–306 (2000). https://doi.org/10.1038/eye.2000.77
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DOI: https://doi.org/10.1038/eye.2000.77
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