Review by Ian Bailey OD, MS, FBCO, FAAO

Ian L Bailey is Professor of Optometry and Vision Science

University of California, Berkeley, California, USA

Driving with Confidence - A practical Guide to Driving with Low Vision

Eli Peli and Doron Peli

Publishers World Scientific Publishing,

Singapore, New Jersey, London.

ISBN 981-02-4704-4

ISBN 981-02-4705-2 (pbk)

In Australia through DA Information Services

Contents    Poster [PDF format, 51 kb]

The Freedom to Drive

Vision and Driving — Facts and Fiction

The Medical Side of Low Vision

Thinking about Driving

Getting Ready to Drive

Learning to Drive

On the Road — Driving with Low Vision

If All Else Fails — How to Get Where You Want Without a Car

Conclusion — Daring to Succeed

Appendices:

Federal Legislation

Information/Aid Sources

Terms You Should Know

Low Vision Driving Aids

State Vision Requirements

Bibliography

Index

 

Readership Visually impaired people and their families, optometrists, ophthalmologists, low vision researchers, legislators, DMV administrators and laypersons.

I strongly support the Peli's main advocacy theme, which is that visually impaired individuals should be afforded more opportunities to demonstrate their potential for safe driving ... I recommend this book to eye care practitioners as a useful source of information, and a resource to share with their visually-impaired patients.

The book’s title aptly reflects the purpose of the book. Eli and Doron Peli have written this book for visually impaired individuals with a view to boosting their confidence in their potential for safe driving. The book provides information about relationships between impaired vision and driving, and it gives advice on how to pursue driving licensure.

Most eye care clinicians will, from time to time, have some uncertainty and discomfort when called on to advise visually-impaired patients about the adequacy of their vision for driving. This book gives clinicians a compact overview of the issues and a set of valuable information resources. Presented in a large print format, the book is a quick and easy read with 9 chapters within 80 pages of text, followed by a 100 page set of appendices. Peli and Peli take an advocacy position with some caution and restraint. They encourage visually impaired individuals to consider whether they might have the visual ability to drive. If they think they might be able to do it, they are advised how to become informed and prepared for driving.

. .

The first two chapters deal with the right to drive and relationships between impaired vision and driving. Research literature is reviewed in a series of discussions of evidence about relationships between 6 visual functions and driving safety. These functions are visual acuity, visual field, colour vision, contrast sensitivity, glare disability and the useful field of vision. Most licensing authorities rely upon visual acuity as the major, if not the only, criterion for deciding an individual’s visual fitness to drive. Peli and Peli appropriately emphasize that visual acuity, or any other single vision function, is not an adequate predictor of driving safety. Many studies are cited to illustrate that each of these various visual functions show only weak correlations with driving safety. Chapter 3 gives brief descriptions of 8 diseases that affect vision: cataract, AMD, glaucoma, diabetes, RP, optic atrophy, corneal dystrophy and stroke. It was a little surprising to find congenital disorders, such as albinism, were not included.

Chapter 4 invites visually impaired readers to consider their own potential for driving, and to consult an eye care practitioner about their vision characteristics and the implications for driving. Potential drivers are advised to learn about visual aids for driving and the laws on vision and driving licensure. Most of the needed information is in the appendices. The next two chapters give advice on obtaining low vision devices and driving instruction. They include guidelines for training oneself to become skilful in using low vision devices for visual tasks of driving.

Chapter 7 lists 19”commandments” for visually impaired drivers, advising them to drive only when it is necessary and only when all conditions and equipment are favorable. They are also given pointers on planning and preparing before each journey, and driving cautiously with maximum concentration. The last 6 pages of text include tips on finding alternative ways to travel if you do not drive.

The appendices will serve as a good resource for the American audience. The 60-page listing of vision requirements for driving in the 50 American states will be directly useful to American optometrists and ophthalmologists. Of more universal value are the 8-page glossary and the 22-page section describing common and uncommon low vision devices that might be used for driving.

Perhaps in the pursuit of brevity and simplicity and the wish to emphasize the positive, some of the complexities have not been tackled directly. In many diseases, losses can occur in several visual functions with functionally important compounding effects. More direct connections between specific vision functions and driving safety can be found in targeted studies rather than the analyses of overall driving populations that Peli and Peli highlight. Screening one function, such as VA, serves more than one purpose. It can be a useful trigger to identify more complex and more functionally significant losses in other visual functions. There should have been discussion of the substantially higher accident rates found in drivers with BiOptic telescopes. There are few errors (image brightness is usually better in Galilean telescopes, not worse) and, technical issues being oversimplified may disappoint low-vision experts

Visual impairment does elevate risk, but how much risk elevation is needed to justify denial of driving privileges? On most issues, Peli and Peli present the pros and cons, but with a steady bias favoring the permissive rather than restrictive. Never-the-less, I strongly support the Peli’s main advocacy theme, which is that visually impaired individuals should be afforded more opportunities to demonstrate their potential for safe driving.

I recommend this book to eye care practitioners as a useful source of information, and a resource to share with their visually-impaired patients.

Other reviews

"... Local researcher, Dr Eli Peli, wrote 'Driving With Confidence' to help people with impaired vision stay on the road."

NewsCenter 5's Heather Unruh

Boston ABC affiliate WCVB Channel 5

"... we have found your book, 'Driving with Confidence: A Practical Guide to Driving with Low Vision', to be a wonderful resource."

Joanne Schwartzberg, MD

Director, Aging and Community Health

American Medical Association's

Older Drivers Project

"This helpful book, printed in LARGE TYPE, contains facts, information, advice and reference materials that will enable those facing deterioration in their vision to make informed decisions about their ability to continue driving."

Visionlink, 2002

Newsletter of International Library

Archives & Museum of Optometry

"Driving with Confidence fills a large gap in the low vision literature and provides a clearly written discussion of viable options and alternatives for driving with low vision ... because countries outside the US are also dealing with these same issues regarding drivers with low vision and the use of optical enhancement devices, I believe the material contained in Peli and Peli would be of strong interest internationally."

Visual Impairment Research, 2002   More, here.  [PDF format 465 Kb]

"The book is clearly written and well structured ... it will inform and empower its intended audience."

CE Optometry, 2002

"I will be enthusiastically recommending this book to my more astute patients (and their families) if they have a reasonable chance of being able to drive safely and legally and are trying to gain greater perspective than I can offer in a clinic visit. I will also recommend this book as a reference for any eye doctors, rehabilitation specialists, and driving instructors who work with a lot of partially sighted patients."

Optometry and Vision Science, Dec 2002