The effect of presbyopic vision corrections on nighttime driving performance.

PURPOSE To investigate the effect of various presbyopic vision corrections on nighttime driving performance on a closed-road driving circuit. METHODS Participants were 11 presbyopes (mean age, 57.3+/-5.8 years), with a mean best sphere distance refractive error of R+0.23+/-1.53 DS and L+0.20+/-1.50 DS, whose only experience of wearing presbyopic vision correction was reading spectacles. The study involved a repeated-measures design by which a participant's nighttime driving performance was assessed on a closed-road circuit while wearing each of four power-matched vision corrections. These included single-vision distance lenses (SV), progressive-addition spectacle lenses (PAL), monovision contact lenses (MV), and multifocal contact lenses (MTF CL) worn in a randomized order. Measures included low-contrast road hazard detection and avoidance, road sign and near target recognition, lane-keeping, driving time, and legibility distance for street signs. Eye movement data (fixation duration and number of fixations) were also recorded. RESULTS Street sign legibility distances were shorter when wearing MV and MTF CL than SV and PAL (P<0.001), and participants drove more slowly with MTF CL than with PALs (P=0.048). Wearing SV resulted in more errors (P<0.001) and in more (P=0.002) and longer (P<0.001) fixations when responding to near targets. Fixation duration was also longer when viewing distant signs with MTF CL than with PAL (P=0.031). CONCLUSIONS Presbyopic vision corrections worn by naive, unadapted wearers affected nighttime driving. Overall, spectacle corrections (PAL and SV) performed well for distance driving tasks, but SV negatively affected viewing near dashboard targets. MTF CL resulted in the shortest legibility distance for street signs and longer fixation times.