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BiOptic Driving Network - Lori L. Grover, OD, FAAO

 

Lori L. Grover, O.D., F.A.A.O.
Vision Rehabilitation Associates of Arizona
Specializing in Vision Rehabilitation and the Care of People With Special Needs

www.azvisionrehab.com

Dr. Grover received her Doctor of Optometry degree from the Illinois College of Optometry in 1990. She also received her B.S.V.S. degree from ICO in 1998. Dr. Grover is a 1985 graduate of Albion College where she received her B.A. in Biology. After graduation from ICO she joined a Certified Low Vision Specialists private group practice in Michigan. In 1995 she established her own private practice in Sylvania, Ohio where she specialized in low vision rehabilitation and coordinated the Bluffton Hospital Low Vision Rehabilitation Specialty Clinic. Dr. Grover accepted appointment at the Southern California College of Optometry in August 2000 where she served as an Assistant Professor and Chief of the Low Vision Rehabilitation Service until June 2003 when her family relocated to Scottsdale, Arizona. Currently Dr. Grover is in private practice and continues to provide consultative services in development and implementation of vision rehabilitation programs.

Picture: Lori L. Grover, OD, FAAO
Dr. Grover is a member of the American Optometric Association Low Vision Rehabilitation Section Executive Council, serving as Chair of Communications Committee and as a member of the State Association Low Vision Committees Task Force. She is a Fellow of the American Academy of Optometry pursuing her Diplomate in Low Vision. She is a member of the Arizona Optometric Association where she serves on the Legislative Committee. She recently served as a Consultant to National Heritage Insurance Company (CMS carrier for California) and was instrumental in the development of regional policy language and implementation of coverage for vision rehabilitative services. She continues to serve on the Health Care Delivery Systems Committee of the California Optometric Association and recently served as President of the Orange County Optometric Society. She served as the first Chair of the Ohio Optometric Association Vision Rehabilitation Committee, and served as the first female President of the Illinois College of Optometry’ Alumni Council. Dr. Grover is a site consultant for the AOA Accreditation Council on Optometric Education, and is frequently featured in television, radio and print media. She is an internationally recognized lecturer and multi-disciplinary speaker in vision rehabilitation. Her research interests include driving with visual impairment, vision rehabilitation accreditation, early intervention models and outcomes assessment.

 

 

DRIVING AND VISUAL IMPAIRMENT

 

Imagine you just had your annual eye examination and your doctor told you that there is a possibility you may have to give up driving in the future due to your vision. Think of the impact this would have on you, your family, and those you care for. What would you do? What options do you have? 

This scenario is common for individuals with macular degeneration, as well as other eye diseases resulting in visual impairment, commonly referred to as "low vision". As a low vision specialist, I discuss this with my patients on a daily basis. For most people, driving is not only a very important privilege, but is also a necessary part of maintaining independent living and travel. When vision is lost as a result of disease, trauma or congenital condition, specific visual requirements needed for driving may be compromised, resulting in an inability to meet standard requirements for legal driving, and restriction or loss of drivers licensure. For example, macular degeneration can affect one's ability to drive by decreasing central vision, which results in reduced ability to discriminate detail. In most cases, good peripheral vision remains, even though the acuity diminishes, and this good "side vision" is what some believe is the most important factor for safe driving.

Many states across the country offer the option of safe and legal driving for people who have less than perfect vision. "Standard" drivers licensure in most states requires a minimum level of visual acuity (how small a target one can discriminate), some states require a minimum level of visual field (the size of the visual window through which we view the world), and may require specific levels of color vision and binocularity. Other levels of licensure include restricted licensure (which can range from requiring the use of glasses or contact lenses to limiting the time of day, distance and speed that one can drive and/or requiring special car mirrors) and BiOptic licensure (requiring the use of a special spectacle prescription system called a BiOptic telescope and possibly specialized drivers training ) are options for individuals who have visual loss. In addition, the requirements for licensure are not consistent and vary dramatically from state to state. As of 2004, 38 states allowed BiOptic licensure for driving (including District of Columbia), 10 states did not allow for BiOptic licensure, and 5 states allowed the use of a BiOptic telescope for driving but only after meeting current DMV requirements. In the state of Colorado, there is no visual field requirement, drivers must have a visual acuity of 20/40 or better for non-restricted licensure, and individuals with acuity less than 20/40 may have restrictions and/or may have BiOptic licensure as determined by the doctor providing vision examination, resulting in a vague and somewhat subjective licensure process. In contrast, in the state of Michigan, drivers are required to see 20/40 for unrestricted licensure, 20/50 to 20/70 for restricted licensure if condition causing low vision is not progressive, 20/50 to 20/60 for restricted licensure if condition causing low vision is progressive; meet the visual field requirements of 110 to 140 degrees for unrestricted licensure, 90 to 110 degrees for restricted licensure, and have a minimum of 90 degrees for any licensure; and BiOptic drivers must have a visual acuity of 20/100 through their regular spectacle prescription and must see at least 20/40 through their BiOptic telescopic system.

In the vast majority of cases, an individual must be examined by a low vision doctor to see if they can pursue BiOptic drivers licensure. Then a BiOptic telescope is prescribed based on their visual needs and the individual is taught how to effectively and efficiently use their vision with the BiOptic. Documentation and forms will need to be completed by the doctor for the Department of Motor Vehicles. This begins the process of gaining licensure if other licensure alternatives have been eliminated.

With appropriate clinical evaluation and the use of BiOptic telescopic systems, many patients across the country are now driving safely and legally with the help of their low vision rehabilitation doctor. It is important to note that this process of obtaining licensure is not just for people who have driven before - many young adults who have attained legal driving age also follow this process as well, and can gain licensure at the same time in their educational process as their peers.

So the next time you talk with an individual who isn't sure what they can do about their driving, remember that there are alternatives to investigate with the help of their low vision doctor. It may be the first time these driving considerations are discussed and presented to the individual and/or their family, and an informed person can make the best choices for their future.

 

 

 

See the presentation Driving and Visual Impairment by Lori L. Grover, O.D., F.A.A.O.
(Microsoft PowerPoint, 109 Kb)

 

Also see "If you don't like the way I drive" by Paul B Freeman O.D.  [160 Kbs PDF format]

 


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