Vision and Driving

Anne Hegberg, M.S., OTR/L

Personal vehicle driving is the most common form of transportation in the United States.  Driving is seen as freedom, independence and necessary.  What is better than hopping in a car on a summer day with the windows down and the music playing?

It is estimated that ninety percent of driving is visual.  What about those whose vision is less than ideal? Vision is not just acuity, the ability to see details.  Vision for driving also includes the ability to perceive depth and distances, as when pulling into a parking space.  Peripheral vision, the ability to be aware of light or motion on the side, is required.  Color perception, visual memory and the ability to handle glare also are needed. 

Anne Hegberg, M.S., OTR/L

Amanda wearing BIOPTIC TELESCOPES

Cognitively, the driver must be able to visually select relevant stimuli in the driving environment and do it quickly.  Approaching a traffic light with pedestrians crossing and cars pulling out of a parking lot is a typical driving situation. 

Can the eyes quickly move and focus from the car braking ahead to the pedestrian starting to walk to the car pulling out of the parking lot and back to the traffic light?

As an Occupational therapist, driving rehabilitation is a specialty area.  The driver  rehabilitation program at Marianjoy Rehabilitation Center was established over twenty years ago. The past ten years we have worked closely with area     vision specialists to maximize the potential for independent driving of those with any vision impairment. 

Our low vision  program addresses two primary areas:  (1) new drivers with congenital visual impairments (such as Ocular Albinism) and  (2) experienced drivers who experience a  decline in vision (such as Macular Degeneration).

In Illinois there are three levels of licensing based on visual acuity — 20/40 (best corrected) visual acuity is required for an unrestricted day and night license, 20/70 visual acuity allows daylight only driving; and for those with “low vision” (20/100), bioptic telescope (BTS) MAY be the answer.  Think of bioptic telescopes as “bifocals for distance.” 

Driving with BTS is not for all drivers with low vision.  Your vision specialist can determine if you meet the state requirements and if BTS are indicated.

As the number of older Americans increase, the number of elderly drivers is expected to increase by almost fifty percent by the year 2020.  It is estimated that visual impairment for Americans over 65 years will also increase significantly from four million (2000) to six million (2020) and nine million (2030).

Many of these drivers will self-regulate, driving during non-rush hours or only in daylight.  Other drivers need some outside assistance to maximize their independence.  Driver Rehabilitation programs work individually with clients to meet their special needs.  As previous drivers, we are not “teaching” the client to drive, but how to adapt to the vision impairment to prolong safe, independent driving.

New drivers are faced with the task of learning driving and learning visual compensation (possibly bioptic telescopes) at the same time.  To give new drivers a head start, commentary driving can begin before driver education. The student should sit in the front passenger seat when a parent is driving and practice his/her visual skills.  The student should employ visual strategies and verbalize to the parent during the drive.  This accomplishes two main goals:

(1) the student is able to practice visual scanning spotting, tracking and other visual skills without the added task of operating the vehicle (when to go through yellow light, when to pull out into traffic…);

(2) the parent can get a better understanding of what the visual impaired student can see and when.

General Compensatory Strategies:

® Allow plenty of time, many accidents are caused by those in a hurry.

® If going to a new destination, get directions by landmarks not just street names.  If you have an important appointment, do a practice run to prevent difficulties.

® When possible, plan your driving based on the sun horizon.  Going west in the early morning and east in the evening;

® Reduce glare from dashboard by placing black felt on top to absorb light.

® If difficulty reading the speedometer, mark common speeds with bright tape (20, 30, 45, 55).

® Wear good sunglasses, different colored tints can be used for varying weather conditions.  See what works best for your vision.

® Keep windshield, windows and mirrors clean.   Remove snow from the entire front and back   windshield.

REMEMBER: 
DRIVING IS A PRIVILEGE
NOT A RIGHT.

Editor’s Note:  Anne Hegberg is an Occupational Therapist at Marianjoy Rehabilitation Center in Wheaton, Ill., specializing in driver rehabilitation. 

(Article Reprinted by Permission.  Pictures Courtesy of Anne Hegberg and the parents of Amanda.)

The Visionary, published as a service of the Illinois Society for the Prevention of Blindness,
is available upon request. The information contained in this issue,
taken from sources considered to be accurate,
does not replace the need for professional eye care consultations and treatments.

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