VISION AND ALCOHOL
Allen, M. J.; Abrams, B. W.; Ginsburg, A. P.; Weintraub, L.; Forensic aspects of vision and highway safety, Boca Raton, Florida, Lawyers and Judges Publishing Company, 1996, pp. 269-271. (As soon as you start to drink, your blood alcohol concentrations, BAC, starts to rise. Driving impairment increases directly with BAC level. Goes on to quote Garriott about color and glare recovery, Brecher about binocular coordination, Moskowitz and visual tracking, and Newman and visual acuity.)
Avant, L. L. "Alcohol impairs visual presence/absence detection more for females than for males," PERCEPTION AND PSYCHO PHYSICS (1990), 48 (3): 285-290. (90 male and female subjects, Breath alcohol, fasted given 3 levels of alcohol 0.0%, 0.5%, or 1.0%. Alcohol produced higher blood alcohol concentration (BAC) levels, and higher detection threshold duration's, for females than for males. These results indicate that alcohol influences pre cortical visual processing and that the influence is greater for females than for males. The higher bioavailability of alcohol in women is likely due to less gastric oxidation of ethanol in women than in men.)
"Effects of alcohol and other drugs on driver performance", TRAFFIC INJURY PREVENTION, (2004), 5(3): 185-98. "In the past century we have learned that driving performance is impaired by alcohol even in low dosage, and that many other drugs are also linked to impairment. This paper is a summary of some of the more relevant studies in the past fifty years--an overview of our knowledge and unanswered questions. There is no evidence of a threshold blood alcohol (BAC) below which impairment does not occur, and there is no defined category of drivers who will not be impaired by alcohol. Alcohol increases not only the probability of collision, but also the probability of poor clinical outcome for injuries sustained when impaired by alcohol. This review samples the results of the myriad studies that have been performed during the last half century as experiments have moved from examination of simple sensory, perceptual and motor behaviors to more complex measures of cognitive functioning such as divided attention and mental workload. These more sophisticated studies show that significant impairment occurs at very low BACs (< 0.02 gm/100 ml). However, much remains to be determined regarding the more emotional aspects of behavior, such as judgment, aggression and risk taking. Considering that the majority of alcohol related accidents occur at night, there is a need for increased examination on the role of fatigue, circadian cycles and sleep loss. The study of the effects of drugs other than alcohol is more complex because of the number of substances of potential interest, the difficulties estimating drug levels and the complexity of the drug/subject interactions. The drugs of current concern are marijuana, the benzodiazepines, other psychoactive medications, the stimulants and the narcotics. No one test or group of tests currently meets the need for detecting and documenting impairment, either in the laboratory or at the roadside."
'Effects of low alcohol consumption on visual evoked potential, visual field and visual contrast sensitivity", ACTA OPATHMALOGICA SCANDINAVIA (1999) Feb; 77(1): 23-6. "PURPOSE: We studied changes in the vision of 16 people after consumption of a small quantity of alcohol, at a blood alcohol level (BAL) of 0.57 g/kg. METHODS: We studied visual contrast sensitivity (VCS) using Vistech VCTS 6500, visual evoked potential (VEP) by checked pattern stimulations and the peripheral visual field (PVF) with a perimetric automatic Humphrey. We first carried out the tests on sober people and then on individuals with a BAL of 0.57 g/kg. RESULTS: Alcohol consumption caused no significant difference in performance for these 3 tests. However, at a BAL of 0.57 g/kg there was a decrease in cerebral function, as shown by an increase in the number of mistakes made in the Wisconsin Card Sorting Test. CONCLUSION: These results suggest that for a low blood alcohol level, visual performance is less affected by the visual changes than by alteration in brain functions."
"Facts about alcohol", Television Corporation of Singapore (1995). ("Recommendations: The legal limit for BAC when operating a motor vehicle should be lowered to 0.050/0. It has been demonstrated in this paper that impairment of vision, motor skills, and cognitive functions occurs at BACs well below the current legal limit of 0.08%, the scientific consensus is that levels of physical impairment significant to the driving task begin at 0.05%. In addition, epidemiologic evidence examined in the document shows that risk of accident begins to increase significantly at or about the 0.05% BAC level.")
Garriott, J. C.; "Pharmacology of ethyl alcohol," In: Garriott, J., ed.; Medicolegal Aspects of Alcohol Determination in Biological Specimens, Littleton, MA, PSG Publishing Company, Inc., c1988, 36-54. (Colors, vision, light, and impairment, etc., pyloric sphincter.)
Hill, J. C.; Toffolon, G.; "Effect of alcohol on sensory and sensorimotor visual functions," JOURNAL OF STUDIES ON ALCOHOL (1990), 51 (2): 108-113. (The literature on the effect of alcohol on sensory and sensorimotor visual functions is extensive. The findings are often contradictory and early studies did not correlate the effects with blood alcohol levels. This study was designed to test the effects of alcohol on various visual functions using equipment that is freely available to the clinician. A significant loss of visual field, accommodation and convergence that correlated with increasing blood alcohol levels was found. Visual acuity, color vision and stereoacuity were not significantly altered by alcohol.)
Mergler, D.; Blain L ; Lemaire J ; Lalande F.; "Colour vision impairment and alcohol consumption",NEUROTOXICOLOGY AND TERATOLOGY (1988), 10(3): 255-60. "The relationship between alcohol intake and colour discrimination capacity was examined among 136 persons of whom 16 were undergoing treatment in a detoxification center. Current weekly alcohol consumption (or prior to treatment for those in the center) was obtained with a detailed questionnaire, which divided week and weekend drinking into types of alcohol (beer, wine, spirits). Alcohol consumption varied from 0-5824 g/week; median: 266 g/week. Qualitative and quantitative assessment of acquired dyschromatopsia was obtained with a colour arrangement test, the Lanthony D-15 desaturated panel. In all age categories, the prevalence of dyschromatopsia increased with alcohol intake. Moreover, all the heavy drinkers (greater than 751 g/week) presented a certain degree of dyschromatopsia, whether or not they were undergoing treatment for alcoholism in a detoxification center. Colour loss was primarily in the blue-yellow range; however, 4 of the 16 persons from the detoxification center presented complex dyschromatopsia patterns including red-green loss. This raises the question of possible progressive deterioration. Multiple regression analysis showed that colour vision loss was significantly related to both age (p less than 0.001) and alcohol intake (p less than 0.01). These results underline the importance of taking into account the contribution of alcohol consumption in studies on acquired dyschromatopsia."
Miller, R. J.; "Ingested ethanol as a factor in double vision," ANNALS OF THE NEW YORK ACADEMY OF SCIENCE (1992), 654: 489-91. (8 male subjects, 11 distances, breath alcohol, trials every 15 minutes for six hours. A frequent symptom of ethanol intoxication is double vision (diplopia), a deterioration of the ability to combine the two eyes' images into one precept (i.e., to achieve fusion) One aspect of fusion ability is fusion latency, the time required to achieve fusion one a target is binocularly visible. A major contributor to successful fusion is the ability to converge or diverge the eyes to an angle appropriate for the distance of the target. The far point of fusion (the maximum distance at which fusion could be attained) decreased significantly as BAL increased. Low sample.)
Miller, R. J.; "The effect of ingested alcohol on fusion latency at various viewing distances. Source: Perception & psychophysics", PERCEPTION AND PSYCHOPHYSICS, (1991), 50(6): 575-83. "Although diplopia is a frequently reported symptom of severe alcohol intoxication, there have been few past attempts to describe in any systematic fashion the specific impact of alcohol on fusion. In the present experiment, fusion latency was assessed for 8 male emmetropes. At the beginning of the alcohol condition, they consumed a drink containing 1.4 ml/kg of 95% ethanol , plus diluent. For the placebo condition, the drink consisted only of diluent. In each condition, fusion latency (the time required to fuse a binocularly visible target) was recorded for targets requiring a magnitude of vengeance that varied from +10 through -2 meter angles, in 1-meter-angle steps. It was found that the far point of fusion approached the observer as a direct function of intoxication level. Furthermore, fusion latency increased for optically far and near targets as a systematic function of intoxication, with no effect of alcohol on intermediate targets. The results were consistent with previous findings of alcohol-induced narrowing of vengeance range, suggesting that alcohol causes the farthest and nearest distances at which fusion latency is affected to approach an intermediate value. Measurable effects on fusion latency were observed with blood alcohol levels as low as 0.05%-0.06%, considerably below the legal limit for operating a motor vehicle in most states."
Moskowitz, H.; Burns, M.; " Effects of alcohol on driving performance," ALCOHOL HEALTH AND RESEARCH WORLD (1990), 14 (1): 12-14. ( A review of the literature. Covers: psychomotor skills, vision, tracking, perception, information processing, and attention.)
Nawrot, M. ; Nordenstrom B ; Olson A; "Disruption of eye movements by ethanol intoxication affects perception of depth from motion parallax,", PSYCHOLOGICAL SCIENCE , (2004), 15(12): 858-65. email@example.com. "Motion parallax, the ability to recover depth from retinal motion generated by observer translation, is important for visual depth perception. Recent work indicates that the perception of depth from motion parallax relies on the slow eye movement system. It is well known that ethanol intoxication reduces the gain of this system, and this produces the horizontal gaze nystagmus that law enforcement's field sobriety test is intended to reveal. The current study demonstrates that because of its influence on the slow eye movement system, ethanol intoxication impairs the perception of depth from motion parallax. Thresholds in a motion parallax task were significantly increased by acute ethanol intoxication, whereas thresholds for an identical test relying on binocular disparity were unaffected. Perhaps a failure of motion parallax plays a role in alcohol-related driving accidents; because of the effects of alcohol on eye movements, intoxicated drivers may have inaccurate or inadequate information for judging the relative depth of obstacles from motion parallax."
Nawrot, Mark:, EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGERY, April, 2005 and also in PSYCHOLOGICAL SCIENCE, December, 2004. Nine males and six females were among volunteers, who first were tested in a sober state to establish that they had normal vision abilities in areas including depth perception and eye movements necessary for tracking motion. Volunteers also were screened to make sure they had no family history of alcoholism, and that they themselves were not problem drinkers. After a baseline of normal vision skills was established, tests were repeated after volunteers began drinking alcohol. The study found that depth perception is harmed even in individuals who had below the .08% legal limit for blood alcohol levels for drivers in the United States and other countries. (15 subjects)
Nicholson, M. E.; Wang, M.; Airhihenbuwa, C. O.; Mahoney, B. S.; Christina, R.; Maney, D. W .;"Variability in behavioral impairment involved in the rising and falling BAC curve", JOURNAL OF STUDIES ON ALCOHOL (1992), 53(4): 349-56. "The purpose of this pilot study was to measure variability in behavior impairment at specific levels of the rising and falling blood alcohol concentration (BAC) curve. Behavior impairment was measured for anticipation and reaction time in addition to a variety of visual skills. Also of interest was the variability in impairment involved at specific BAC levels under single-dose and double-dose conditions. The experimental design was a variation on a 2 x 2 factorial with repeated measures on the dose of alcohol. All subjects took part in two experimental sessions, single-dose and double-dose. Sixteen (8 male and 8 female) paid subjects ages 21-40 participated in the study. Testing procedures included repeated measures on reaction time, anticipation time, perceptual vision acuity and depth perception. Breath-alcohol measures were sampled continuously at 5-minute intervals and used to plot absorption time, peak BAC and elimination time. Results showed that the average peak BAC for the double-dose was significantly higher than that of the single-dose condition. However, there were no significant differences between the single-dose and double-dose condition in either absorption time or elimination time. The performance pattern for reaction time, anticipation time and depth perception showed more impairment in the rising BAC limb than in the falling BAC limb. It is noteworthy that specific individuals exhibited different levels of impairment at a given BAC level, depending on whether the session was single- or double-dose, suggesting that one's current BAC level is less a measure of impairment than is the total quantity of alcohol consumed. A follow-up procedure to examine practice effects was conducted on eight volunteer students. Identical testing procedures, using no alcohol, produced no significant practice effects after a 3-hour period."
Quintyn, J. C.; Massy J; Quillard, M ; Brasseur, G: "The case for a 0.05% criminal law blood alcohol concentration limit for driving", INJURY PREVENTION (2002), Sep; 8 Suppl 3: iii1-iii17.
Russell, R. M.; Carney, E. A.; Feiock, K.; Garrett, M.; Karwoski, P.; "Acute ethanol administration causes transient impairment of blue-yellow color vision," ALCOHOLISM: CLINICAL AND EXPERIMENTAL RESEARCH (1980), 4 (4): 396-399. (14 alcoholic subjects and 12 nonalcoholic subjects, breath and blood analysis. The acute administration of ethanol to alcoholics and normal subjects transiently resulted in poorer color discrimination in all spectra but with significantly more errors in the blue-yellow versus the red-green color range. Thus, ethanol appears to act as a toxin to inner retinal layers, which could account for the higher incidence of tritanopia found among alcoholics. Damage to the cell layer or optic nerve mainly results in a reduction of red-green color sense.)
Schneider ,U.; Leweke, F. M.; Niemcyzk, W.; Sternemann, U.; Bevilacqua, M.; Emrich, H. M.; "Impaired binocular depth inversion in patients with alcohol withdrawal", JOURNAL OF PSYCHIATRIC RESEARCH(1996), Nov-Dec; 30(6): 469-74. "Binocular depth inversion represents an illusion of visual perception. Such inversion does not occur in all cases, especially when objects with a higher degree of familiarity (e.g. photographs of faces) are displayed. Cognitive factors are assumed to override the binocular disparity cues of stereopsis. We tested the hypothesis that during alcohol withdrawal the human CNS is unable to correct the implausible perceptual hypothesis. Measurements of binocular depth inversion in perception of 3D objects were performed in 10 patients with mild alcohol withdrawal and in 11 healthy volunteers. The binocular depth inversion scores were highly elevated in the patients group in comparison to the healthy volunteers. The data demonstrates a strong impairment of binocular depth inversion in alcohol withdrawal and support the view that alcohol withdrawal may be accompanied by a disorganization of the interaction between sensory input and generation of perceptual hypotheses."
Shimozono, Michele; Townsend John C.; Ilsen, Pauline F.; Bright, David C.; "Acute vision loss resulting from complications of ethanol abuse", JOURNAL OF THE AMERICAN OPTOMETRIC ASSOCIATION (1998): 69 (5): 293-303. "Alcoholism affects about 10% of men and 3% to 5% of women in their lifetime. It is a primary chronic disease with genetic, prosocial, and environmental factors that influence its development. The genetic, psyhocosocial, and systemic effects of ethanol abuse--including anemia, cardiomyopathy, gastric/duodenal ulceration, pancreatitis, and neurologic deficits--are review. Appropriate treatment and management of ocular manifestations and complications from alcoholism are discussed. Prophylactic topical therapy may be indicated to restore the balance between intraocular tension and optic nerve head perfusion in an attempt to prevent further axonal loss. Conclusion: Alcohol-induced nutritional optic neuropathy should not be viewed as an isolated ocular entity, but rather as a potentially treatable neurologic problem. An interdisciplinary approach is essential optimal in the management of the alcoholic patient."
Toro, K.; Hubay, M.; Sotonyi, P.; Keller, E., "Fatal traffic injuries among pedestrians, bicyclists and motor vehicle occupants", FORENSIC SCIENCE INTERNATIONAL (2005), 151 (2-3): 151-156. Durkins et al. reported that peak incidence of pedestrian and bicyclist injuries occurred during the summer months and afternoon hours; whereas motor vehicle occupant injuries showed little seasonal variation and they were more common during evening and nighttime hours. Motor vehicle crashes are the greatest cause of potential years of life lost among the economically active male population. Ostrom and Ericcson suggested that the public should be enlightened of the fact that drinking is a risk for traffic accidents not only among users of motor vehicles, but also among pedestrians. The mortality rate emphasizes the necessity of prevention strategies that may include proper supervision and risk reduction with respect to use of alcohol or drugs.
Wang, M. Q.; Taylor-Nicholson, M. E.; Airhihenbuwa, C. O.; Mahoney, B. S.; Fitzhugh, E. C.; Christina, R.; "Psychomotor and visual performance under the time-course effect of alcohol", PERCEPTUAL AND MOTOR SKILLS (1992) 75(3) Pt 2: 1095-106. "This study examined reaction time (RT), anticipation time (AT), and visual performance under the influence of blood alcohol concentration (BAC), using a repeated-measures design. Subjects (8 men and 8 women), 21 to 40 yr. of age, participated in both single- and double-dose sessions, in which they drank approximately 2.3 oz. and 4.6 oz. of 86-proof vodka, respectively. The breath BAC was measured at 5-min. intervals. The RT, AT, and visual performance were tested every 20 min. for 140 min. in both sessions. In general, results indicated that RT, AT, and stereoscopic vision were impaired more in the rising BAC curve than the falling BAC curve. In addition, the impairment tended to be greater for the double-dose than the single-dose session. The far and near visual acuities were not affected by the BAC". (Only 16 participants.)
Warren, R. G.; Lie,I.; "Visual functions and acute ingestion of alcohol", OPHTHALMIC AND PHYSIOLOGICAL OPTICS (1996), 16 (6): 460-466. (22 males subjects, BrAC) Visual acuity and refraction were only significantly affected at the 0.1 percent BrAC level. Contrast sensitivity, stereoacuity and binocular vision were affected at both 0.05 percent and 0.1 percent BrAC concentrations. Only the higher spatial frequencies of contrast sensitivity were affected. These results confirm previous findings on the detrimental effects of alcohol upon oculomotor control, showing a considerable decrease in both positive relative convergence and negative relative convergence.
1. The state of being dichromatic
2. A form of colorblindness in which only two of the three fundamental colors can be distinguished due to a lack of one of the retinal cone pigments. Also called dichromatopsia, dyschromatopsia, parachromatopsia.