Personal Assessment of Ability to Drive Under the Influence of Alcohol vs. Objective Measurement

Author(s):  
Blake Bashor ◽  
Kelly Hay ◽  
Jill Stoltzfus ◽  
Holly Stankewicz

Background: The pupillary reaction is controlled by the two main branches of the autonomic nervous system, namely the parasympathetic and sympathetic nervous systems. New discoveries in pupil research has identified that intrinsically photosensitive retinal ganglion cells have an impact on pupillary constriction, particularly sustained pupillary constriction. In the current paper, an objective measurement of sustained pupillary constriction versus the inability to maintain sustained pupillary constriction are observed. The variability in the sustained pupillary constriction, i.e. Alpha Omega pupil, can be objectively identified with the use of modern technology. Case Examples: Two female subjects were adapted to dim illumination, and then two objective pupil measurements of the right eye using Reflex – PLR Analyzer by BrightLamp© (Indianapolis, IN, USA) with sustained illumination were obtained. Subject 1, a 25 year-old-female, demonstrated normal ability of the pupil to constrict and sustain constriction for 10 seconds. She was used as a control for subject 2. Subject 2, a 27 year-old-female, demonstrated the inability to sustain pupillary constriction. She reported being under great psychological stress. Her pupil began to re-dilate between 2 and 3 seconds after the initial constriction. Conclusion: Objective pupillometry can be used to assist in many diagnoses and provides the clinician invaluable information on the state of the individual, and qualifications of sustained pupillary constriction can now be assessed in an objective manner.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 302-303
Author(s):  
Stephanie Yamin ◽  
Roxana Manoiu ◽  
Gary Naglie ◽  
Sarah Sanford ◽  
Elaine Stasiulis ◽  
...  

Abstract Driving often provides a sense of independence, quality of life and emotional wellbeing. For older adults living with dementia, driving cessation eventually becomes inevitable. Driving cessation has been shown to negatively impact older adults’ mobility and, consequently, quality of life. Caregivers of persons with dementia (PWD) who have ceased driving are also impacted as they often become responsible for meeting the mobility needs of PWD and they provide emotional support in respect to this significant life transition. To date, there is little information on the role of gender in the transition to driving cessation in PWD. The purpose of this study was to examine the role that gender plays among drivers and ex-drivers with dementia from the perspectives of PWD, their caregivers, and healthcare practitioners. Secondary thematic analyses were conducted from a pre-existing sample of persons with dementia (N=10), family caregivers (N=13), and healthcare practitioners (N=6) who participated in interviews and focus groups about their experiences around driving cessation in the context of dementia. Data analyses involved an inductive thematic technique that allowed for generating themes. The main themes identified gender differences as a significant factor in: (1) difficulty accepting driving cessation (2) driving as it is tied to identity, (3) emotional responses to driving cessation, (4) driving as part of the caregiving role. The findings suggest that there is a need for tailored interventions for men and women who lose their ability to drive, in addressing their unique emotional responses and in supporting them through this important life transition.


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