The UFOV: Useful Field of View

Deciding whether or not a patient can continue to drive after a brain injury is often a difficult challenge for the clinician. The physical, mental and cognitive processing effects of the brain injury must be carefully evaluated. We also look at the patient’s driving history, family input, visual acuities, visual fields, contrast sensitivity, visual fields, mental status and the Useful Field of View Test (UFOV).

We continue to find the UFOV test helpful in assessing potential driving safety in patients with mild vision loss and in neurological cases such as traumatic brain injury, stroke, early Alzheimer’s and cerebral palsy. This tests looks at a central area of the visual field, but unlike a visual field test, it looks at how the patient can perceptually respond to multiple things occurring within the central vision, an area of “useful field of view.”

Our practice was a beta test site for this unique test developed at the University of Alabama. It has now been validated through over fifty scientific papers. It has the highest correlation in predicting crash risk of any vision test. We are pleased to be one of the few optometric practices in the country to offer this test.

The UFOV is a test that assesses parallel attentional processing. It has been shown to help predict crash risk in older drivers. It is a computer administered and scored test. The test includes three subsets, which measures the ability to perform a central visual identification task, to divide attention between central and peripheral stimuli and to select peripheral stimuli from among distracters. It has been defined as the area from which one can extract visual information in a brief glance without head or eye movement.

Part 1: The participant identifies a target presented in the center of the computer screen for varying lengths of time.

Part 2: The participant identifies a target object as before but must also localize a simultaneously presented target object displayed in the periphery of the screen.

Part 3: This part is similar to part 2 except that the target objects displayed in the periphery is embedded in distracters that make the task more difficult.

The limits of this area are reduced by poor vision, difficulty dividing attention and/or ignoring distraction, and slower processing ability. The area from which a driver can extract visual information at a quick glance declines, as people grow older as does the time it takes to process that information. UFOV researchers have defined cognitive impairment as a 40% reduction in the Useful Field of View, and it is the point at which the risk of crashing increases significantly. 

Target objects are presented on the computer monitor. The information presented from simple to complex and presentation time between presentations of the two stimuli varies depending on the participant’s pattern of performance. 

Useful Use of View Test UFOV - Reference List

Sekuler, R. & Ball, K. Measuring older persons' functional visual fields. (1985). Investigative Ophthalmology and Visual Science Suppl., 1985, 26, 307. 

Ball, D., Ball, K., Miller, R., Roenker, D., White, D. & Griggs, D. (1986).Bases for expanded functional visual fields as a result of practice. Investigative Ophthalmology and Visual Science Suppl., 1986, 27, 111. 

Sekuler, R. & Ball, K. Visual localization: Age and Practice. (1986). Journal of the Optical Society A, 1986, 3, 864-867. 

Ball, K., Beard, B., Miller, R. & Roenker, D. (1987). Mapping the useful field of view as a function of age. The Gerontologist, 1987, 27, 166A. 

Ball, K., Beard, B., Roenker, D., Miller, R. & Ball, D. (1988). Visual search: Age and practice.
Investigative Ophthalmology and Visual Science Suppl., 1988, 29, 448. 

Ball, K., Beard, B., Roenker, D., Miller, R. & Griggs, D. (1988). Age and visual search: Expanding the Useful Field of View. Journal of the Optical Society A, 1988, 5(12), 2210-2219. 

Ball, K., Owsley, C., Beard, B., Roenker, D. & Ball, D. (1989). Age and functional vision as related to everyday performance. Investigative Ophthalmology and Visual Science Suppl., 1989, 30, 408. 

Ball, K. Functional vision as related to driving performance. Proceedings of the NIH/DOT/CDC Workshop on the Older Driver, Bethesda, August, 1989. 

Ball, K., Roenker, D. & Bruni, J. (1990). The use of functional vision assessment in predicting mobility problems in older adults. In Digest of Topical Meeting on Noninvasive Assessment of the Visual System, 1990, 3, 138-141. 

Ball, K., Roenker, D., Bruni, J., Jackson, L., Dahl, R., & Rowan, M. (1990). Age and Visual Search: Bases for Shrinkage of the Useful Field of View. Investigative Ophthalmology and Visual Science Suppl., 1990, 31, 1748. 

Ball, K. A Comprehensive Approach to Assessment of the Older Driver. Invited paper for the Conference on Driver Competency Assessment of the California Dept. of Motor Vehicles, October, 1990. 

Ball, K., Owsley, C. & Beard, B. (1990). Clinical visual perimetry underestimates peripheral field problems in older adults. Clinical Vision Sciences, 5, 113-125. 

Ball, K., Roenker, D. & Bruni, J. (1990). Developmental changes in attention and visual search throughout adulthood. In Enns, J. (Ed.), The Development of Attention: Research and Theory. North Holland: Elsevier Science Publishers, 489-508. 

Sloane, M. E., Owsley, C. & Ball, K. (1991). Visual Correlates of Vehicle Accidents in Older Drivers. In Digest of Topical Meeting on Noninvasive Assessment of the Visual System,.

Ball, K., Roenker, D., Bruni, J., Owsley, C., Sloane, M., Ball, D., & O'Connor, K. (1991). Driving and visual search: Expanding the Useful Field of View. Investigative Ophthalmology and Visual Science Suppl., 32, 1041. 

Owsley, C., Ball, K., Sloane, M., Roenker, D.L. & Bruni, J.R. (1991). Visual Perceptual/Cognitive Correlates of Vehicle Accidents in Older Drivers. Psychology and Aging, 6, 403-415. 

Ball, K., Owsley, C. (1991). Identifying Correlates of Accident Involvement in the Older Driver, Human Factors, 33(5), 583-595. 

Ball, K., & Owsley, C. (1993). The useful field of view test: A new technique for evaluating age-related declines in visual function. Journal of the American Optometric Association, 64, 71-79. 

Ball, K., Owsley, C., Sloane, M.D., Roenker, D.L., & Bruni, J.R. (1993). Visual attention problems as a predictor of vehicle accidents in older drivers. Investigative Ophthalmology and Visual Science, 34, 3110-3123. 

Owsley, C., & Ball, K. (1993). Assessing visual function in the older driver. Clinics in Geriatric Medicine: Medical Considerations in the Older Driver, 9, 389-401.

Ball, K., & Rebok, G. (1994). Evaluating the driving ability of older adults. The Journal of Applied Gerontology, 13, 20-38. 

Owsley, C. (1994). Vision and driving in the elderly. Optometry and Vision Science, 71, 727-735. 

Owsley, C., Ball, K., & Keeton, D.M. (1995). Relationship between visual sensitivity and target localization in older adults. Vision Research, 35, 579-587. 

Owsley, C. (1996). Quality of life and vision impairment: Driving. In D.R. Anderson, S.M. Drance (Eds.) Encounters in Glaucoma Research 3: How to Ascertain Progression and Outcome. New York: Kluger Publications, pp. 37-44. 

Rizzo, M., & Dingus, T. (1996). Driving in neurological disease. The Neurologist, 2, 1-20, 1996. 

Ball, K., (1997). Enhancing mobility in the elderly: Attentional interventions for driving. In S.M.C. Dollinger & L.F. Dilalla (Eds). Assessment and Intervention Issues Across the Lifespan: Lawrence Erlbaum Associates, Publishers, pp. 267- 292. 

Ball, K. (1997). Attentional problems and older drivers. Alzheimer Disease and Associated Disorders, 11, 1-6. 

Fisk, G., Owsley, C., & Pulley, L. (1997). Driving following stroke: driving exposure, advice and evaluations. Archives of Physical Medicine and Rehabilitation, 78, 1338-1345. 

Owsley, C. (1997). Clinical and research issues in older drivers. Alzheimer Disease and Associate Disorders, 11, (Supplement) 3-7. 

Owsley, C., Allman, R.M., Gossman, M., Kells, S., & Sims, R. (in press). Mobility impairment and its consequences in the elderly: A theoretical perspective. In J.M. Clair and R. 

Allman (Eds). Multidisciplinary Perspectives on Aging: Progress and Priorities. 

Reinach, S.J., Rizzo, M., & McGehee, D.V. (1997). Driving with Alzheimer's disease: The anatomy of a crash. Alzheimer's Disease and Associated Disorders, 11,21-27. 

Rizzo, M., Reinach, S., McGehee, D., & Dawson, J. (1997). Simulated car crashes and crash predictors in drivers with Alzheimer's disease. Archives of Neurology, 54, 545-53. 

Owsley, C., McGwin., G., & Ball, K. (1998). Vision impairment, eye disease, and injurious motor vehicle crashes in the elderly. Ophthalmic Epidemiology, 5, 101- 113. 

Ball, K. Increasing mobility and reducing accidents in older drivers. The proceedings of Social Structure and Mobility in the Elderly. Conference held at Penn State (1997). Springer Publishing. 

Ball, K., Owsley, C., Stalvey, B., Roenker, D.L., Sloane, M.E., & Graves, M. (1998). Driving avoidance and functional impairment in older drivers. Accident Analysis and Prevention, 30, 313-322. 

Goode, K.T., Ball, K., Sloane, M., Roenker, D.L., Roth, D.L., Myers, R.S., & Owsley, C. (1998). Useful field of view and other neurocognitive indicatiors of crash risk in older adults. Journal of Clinical Psychology in Medical Settings, 5, 425-440.

McGwin, G., Owsley, C., & Ball, K. (1998). Identifying crash involvement among older drivers: Agreement between self-report and state-records. Accident Analysis and Prevention, 30, 781-91.

Sims, R.V., Owsley, C., Allman, R.M., Ball, K., & Smoot, T.M. (1998). A preliminary assessment of the medical and functional factors associated with vehicle crashes in older adults. Journal of the American Geriatrics Society, 46, 556-561. 

Owsley, C., Ball, K., McGwin, G., Sloane, M., Roenker, D.L., White,M.F., & Overley,T. (1998). Predicting future crash involvement in older drivers:Who is at risk? Journal of the American Medical Association, 279, 1083-1088. 

Ball, K., Roenker, D., Rizzo, M., & McGehee, D. (2000). Cognitive training to improve driving competence. The Gerontologist, 40(Special Issue 1), 41. 

Fisk, G.D., Novack, T., Mennemeier, M.,& Roenker, D.(2002). Useful Field of View following traumatic brain injury. Journal of Traumatic Brain Injury, 17, 16-25. 

Edwards, J.D., Wadley, V.G., Myers, R.S., Roenker, D.L., Cissell, G.M. & Ball, K.K. (2002). Transfer of a speed of processing intervention to near and far cognitive functions. Gerontology, 28, 329-340. 

Ball, K.K., Wadley, V.G., & Edwards, J.D. (2002). Advances in technology used to assess and retrain older adults. Gerontechnology, 1, 251-261.

Ball, K.K. & Owsley, C. (2003). Driving Competence: Its not a matter of age. Journal of the American Geriatrics Society, 15, 1499-1501. 

Ball, K.K., Wadley, V. & Roenker, D.L. (2003) Obstacles in implementing research outcomes in community settings. The Gerontologist, 43, 29-36. 

Roenker, D.L, Cissel, G.M., Ball, K.K., Wadley, V., & Edwards, J. (2003) .The effects of speed of processing and driving simulator training on driving performance. Human Factors, 45, 218-233.

Wood, K. M., Edward, J.D., Clay, O. J., Wadley, V. G., Roenker, D.L., and Ball, K.K. (2005) Sensory and cognitive predictors of functional ability in older adults. Gerontology, 51(2),131-141. 

Wadley,V.G., Benz, R., Ball, K.K., Roenker, D.L., Edwards, J.D., & Vance, D.L. (2006). Development and evaluation of home-based speed-of-processing training for older adults. Archives of Physical Medicine Rehabilitation, 87, 757- 763. 

Vance, D.E., Roenker, D.L., Cissell, G.M., Edwards, J.D., Wadley, V.G., & Ball, K.K. (2006). Predictors of driving exposure and avoidance in a field study of older drivers from the state of Maryland. Accident Analysis and Prevention, 38(4),823- 831.

Vance D.E., Ball K.K,. Roenker D.L., Wadley V.G., Edwards J.D. and Cissell G.M. (2006). Predictors of Falling in Older Maryland Drivers: A Structural- Equation Model. Journal of Aging and Physical Activity; 14(3),254-269. 

Clay, O. J., Wadley, V. G., Edwards, J., Roth, D. L., Roenker, D., & Ball, K. K. (2005). The Useful Field of View as a predictor of driving performance in older adults: A cumulative meta-analysis. Optometry & Vision Science, 82, 724-731. 

Edwards, J.D., Vance, D.E., Wadley, V.G., Cissell, G.M., Roenker, D.L., & Ball, K.K. (2005). Reliability and validity of Useful Field of View test scores as administered by personal computer. Journal of Clinical and Experimental Neuropsychology, 27, 529-543.

Vance, D.E., Wadley, V.G., Ball, K.K., Roenker, D.L., & Rizzo, M. (2005). The effects of physical activity and sedentary behavior on cognitive health in older adults. Journal of Aging and Physical Activity, 13, 294-313. 

Wood, K. M., Edward, J.D., Clay, O. J., Wadley, V. G., Roenker, D.L., and Ball, K.K. (2005) Sensory and cognitive predictors of functional ability in older adults. Gerontology, 51, 131-142. 

Edwards, J.D., Wadley, V.G., Vance, D.E., Wood, K., Roenker, D.L., & Ball, K.K.(2005). The impact of speed of processing training on cognitive and everyday performance. Aging & Mental Health, 9,1-10. 

Ball K.K., Edwards, J.D., & Ross, L.A. (2007). The impact of speed of processing training on cognitive and everyday functions. J Gerontolology:Series B; 62B (1):19-31. 

Okonkwo O.C., Crowe, M., Wadley, V.G, and Ball, K. K. (2007). Visual attention and self- regulation of driving among older adults. Int Psychogeriatr,1-12. 

Vance, D., Dawson, J., Wadley. V.G., Edwards, J.E., Roenker, D.L., Rizzo, M., & Ball K. (2007).The Accelerate Study: The Longitudinal Effect of Speed of Processing Training on Cognitive Performance of Older Adults. Rehabilitation Psychology, 52(1),89-96. 

Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Koepke KM, Morris JN, Rebok GW, Unverzagt FW, Stoddard AM, Wright E, for the ACTIVE Study Group. (2006).Long- term Effects of Cognitive Training on Everyday Functional Outcomes in Older Adults. JAMA, 296(23), 2805-2814. 

Clay, O. J., Wadley, V. G., Edwards, J., Roth, D. L., Roenker, D., & Ball, K. K. (2005). The Useful Field of View as a predictor of driving performance in older adults: A cumulative meta-analysis. Optometry & Vision Science, 82, 724-731.