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Statement on the use of BiOptic telescopes for driving
The American Optometric Association acknowledges that driving is not a right but a privilege. Issues related to public safety are of primary concern. However, access to driving privilege should not categorically be denied to individuals who may have reduced visual acuity but with adequate residual vision and cognition and who demonstrate ability as qualified, competent drivers. This paper describes the BiOptic driving population, the multifaceted aspects of vision, principles of BiOptic telescopes, current vision criteria used for drivers licensure, and multidisciplinary adaptive driver education programming. It reviews current research and suggests areas of future research and interdisciplinary cooperation. The American Optometric Association calls for a rational approach to consideration of individuals adapted to BiOptic telescopic spectacles who apply for drivers licensure.
Current figures show that approximately 10 million Americans are significantly visually impaired today, (1) and U.S. Census projections and other sources indicate as many as 15.7 million will be visually handicapped by the year 2050, ranging from mild impairment to total blindness.(2,3) The majority of these individuals have distance visual acuity in the 20/50 to 20/200 range. Visual acuity alone may be a useful quantitative measure, but does not provide a qualitative measure of the multifaceted visual skills that impact driving. Abilities related to visual field, color perception, contrast discrimination, photosensitivity and glare recovery, oculomotor skills, etc., along with cognitive factors vary in the visually handicapped population suggesting the need for thorough evaluation and individual consideration. (4-20)
Access to independent mobility at any level is a primary goal in vision rehabilitation. Livelihoods may depend on independent mechanized mobility. For the purposes of this paper the segment of the "low vision" population referred to has undergone a current comprehensive low vision evaluation by an optometrist or ophthalmologist assessing the status of ocular pathology and addressing the multiple visual factors described above. Prescription of BiOptic telescopic spectacles may be appropriate to meet a variety of visual needs especially in relation to education, employment and ambulatory mobility. The optometrist or ophthalmologist may have the opportunity to select candidates who may be able to master dynamic skills required for driving with the use of BiOptic telescopes. The eye care practitioner may work with associated professionals in blind rehabilitation, driver education, occupational and physical therapy and/or state driver improvement departments to assist appropriate individuals in gaining drivers licenses. As of June, 1994, 29 states permit driving with BiOptic telescopic lenses.(21) Obtaining BiOptic telescopic spectacles does not guarantee that an individual will be granted a drivers license in those states. The effectiveness of an individual's visual and functional performance with the BiOptic telescopic system should be the determining factor for the licensing agency on a case-by-case basis.
BiOptic telescopes are spectacle mounted devices that magnify distant objects. They are permanently fixed on a spectacle carrier lens fabricated to the patient's conventional prescription (and tint, when appropriate). BiOptic telescopes are mounted off axis, usually in the superior position but, depending on the patient's need, may be fixed in other positions. They may be monocular or binocular. A few states require superior mounting; most do not specify telescopic placement. Diversity in technology of telescopic design requires an individual approach to fitting, training and specific use while driving. (5-15,21,22) See this page regarding fitting a BiOptic.
Issues related to BiOptic telescopes and driving are well documented. (4,10,21-24) Individuals using BiOptic telescopes for driving view mainly through the prescriptive earner lens thus maintaining visual field as though viewing through conventional spectacles. Persons eligible for licensure with BiOptic telescopes are those select individuals who are able to see large objects through their carrier lenses but may not be able to discern details or read signage from great distances. When detailed vision is required, telescopic view is engaged with a head and/or eye movement - thus the term "BiOptic". One criticism of the use of BiOptic telescopes for driving stems from the misconception that the telescope portion is used continually, thus limiting visual field.(24) Actually, the telescopic portion of the BiOptic system is in use only a small percentage of driving time. (21) When the concept is understood and mastered, this misconception erodes.
Two types of drivers licenses for persons with reduced visual acuity currently exist nationally, though specific criteria vary from state to state:
Some individuals may obtain licenses that are a combination of both types. License renewal policies vary widely from state to state.
Requirements for both distance visual acuity and field specifications do not necessarily provide a qualitative understanding of the individual's visual performance and driving skill. Cognition and perceptual ability play important roles in addition to visual skills outlined previously. Multidisciplinary adaptive driver education programs can be very helpful in training potential candidates in efficient usage techniques and other compensatory and defensive driving techniques. (4-6)
Data regarding driving with BiOptic telescopes is insufficient to categorically deny driving privileges to BiOptic users. Small samples to date generally show that BiOptic drivers fare as well or better than groups of other licensed handicapped populations. (9,21-23)
Larger samples and formalized cooperative studies are necessary to reach conclusions that impact public safety and access to independent mechanized mobility for BiOptic users. Necessary studies could not be designed or administered if BiOptic users are denied the opportunity to demonstrate their driving performance. Funding for these studies should receive priority in the national research plan.
Note: This paper deals with use of BiOptic telescopes for driving only. A separate document addressing general issues regarding vision function and driving is currently in process.
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Disclaimer statement: BiOptic Driving Network does not sell, endorse, or offer opinions on products, manufacturers, or professionals whose services/products may be secured following posting on this website. Products and individuals pictures on this site have been specifically authorized by the relevant manufacturer or individual. We are a registered not for profit organization, and provide information to help make informed choices. We do not give individuals optometric or ophthalmologic advice, but may refer one to an eminent expert. A BiOptic Telescopic System does not itself make someone a safe driver; specialized training is prerequisite.