Effect of Presbyopic Vision Corrections on Driving Difficulty

Researchers Byoung Sun Chu, Joanne M. Wood, and Michael J. Collins aimed to assess subjective driving difficulty across various presbyopic vision corrections.
The study used a questionnaire with five-point and seven-point Likert scales, subsequently converted to percentages (0\text{%}–100\text{%} satisfaction).
The methodology compared five groups ( $n = 255$ total):
- No correction ( $n = 50$ ).
- Bifocal spectacles ( $n = 54$ ).
- Progressive addition lenses (PALs) ( $n = 50$ ).
- Monovision contact lenses ( $n = 53$ ).
- Multifocal contact lenses ( $n = 48$ ).
Participants were aged $45$ to $70$ years, with a mean age of $55.1 \pm 6.2$ years.

Daytime Performance: Overall satisfaction was relatively high (approximately 80\text{%}) for all groups during the day.
Nighttime Performance: Multifocal contact lens wearers were significantly less satisfied at night ( $P = 0.001$ ), reporting the greatest decrease in satisfaction from day to night conditions ( $P = 0.025$ ).
Glare and Haloes: Multifocal and monovision contact lens wearers experienced significant disturbances from glare ( $P = 0.001$ ) and haloes ( $P = 0.001$ ) compared to spectacle wearers and the no correction group.
Peripheral Vision: PALs wearers reported the most frequent peripheral blur ( $P = 0.004$ ) and distorted movement of objects ( $P = 0.033$ ).
Intermediate and Near Tasks: Drivers with no optical correction reported the highest difficulty with near tasks, such as reading a street directory ( $P = 0.0001$ ), and intermediate tasks like viewing the odometer ( $P = 0.018$ ).
Changing Focus: Bifocal spectacle wearers experienced more difficulty changing focus between near and far distances compared to the PALs group ( $P = 0.002$ ) and more abrupt image changes ( $P = 0.016$ ).

Street Sign Clarity: Multifocal contact lens and bifocal wearers reported lower satisfaction with sign clarity at night compared to PALs wearers ( $P = 0.017$ ).
Odometer and In-Vehicle Devices: Difficulty viewing the odometer was highest for the no correction group during the day ( $P = 0.0001$ ); this difficulty is noted as increasingly relevant due to the rise of in-vehicle technology like GPS.
Depth and Motion Perception: While monovision contact lenses are known to reduce stereoacuity, this study found no significant subjective difference between groups in judging car distances or movement at roundabouts during the day.
Side Mirrors: Multifocal contact lens wearers reported lower clarity when using side mirrors at night ( $P = 0.0001$ ).

Subjective driving experiences for presbyopes vary significantly based on correction type and ambient lighting levels.
Multifocal contact lenses are particularly susceptible to performance loss at night, likely due to increased pupil size and higher-order aberrations.
Eye-care practitioners should tailor vision correction prescriptions to a patient's specific driving needs, especially regarding nighttime driving requirements.