E Peli
Harvard Medical School, The Schepens Eye Research Institute, Boston, United States
Fitness to drive should be determine by the (dis)ability to drive safely, but the states define qualification for driving in terms of visual impairments. The relations between various vision impairments and driving abilities without and with visual aids are weak or unknown. As a result the regulations set by various jurisdictions vary widely, producing very different low vision drivers in different states. This non-uniformity of law is unfair to some and may be dangerous for others. Questionnaires were sent to all states requesting current information regarding low vision driving. Responses were tabulated and returned for confirmation or clarifications. The data were analyzed to determine variability across the country. While visual acuity requirements for non-restricted license are fairly uniform, the visual field requirements for unrestricted license vary greatly across the country (only 34 states have such regulations). Thirty-four states permit driving with bioptic telescopes as compensation for visual acuity loss, but the specific regulations are highly variable. The most diverse regulations are those concerning restricted visual field and hemianopia in particular. Besides rearview mirrors there are no visual field expansions visual aids recognized as driving aids and in some states all such aids are explicitly prohibited. The number of states permitting bioptics is increasing, but specific regulations are continuously changing with little scientific input. The use of telescopic aids remains controversial. Performance with field expansion aids in driving is not known. Driving studies of patients with low vision are needed to increase uniformity. We are embarking on series of studies to address these issues with on-the-road and simulator studies, using a novel visual aid for hemianopia, evaluating the use of bioptics and assessing the impact of restricted peripheral field.
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