A Demonstration Project on Driving with Reduced Visual Acuity and a Bioptic Telescope System in the Netherlands

Abstract

Background: In Europe, driving a passenger car is prohibited if binocular best corrected visual acuity (BCVA) is below 0.5 (20/40). Some US states allow people with reduced visual acuity to use a bioptic telescope system when driving. The aim of our study is to introduce a bioptic telescope system for driving in the Netherlands and to investigate whether it enables people with reduced visual acuity to gain sufficient practical fitness to drive in a European setting. Results: Out of 378 persons who applied for information following media attention for the project, 160 candidates volunteered to participate. Based on the available information, 36 subjects (binocular BCVA: 0.16-0.5 [20/125-20/40]) were invited for assessment (vision, mobility, cognitive function, and driving skills). Of these, 16 did not meet the inclusion criteria and 2 decided not to participate. The remaining 18 subjects were trained in the use of a monocular bioptic telescope (3× magnification). They all completed the predriving training successfully and received driving lessons from specialized professional driving instructors. Eventually, 9 subjects passed the official on-road test of practical fitness to drive, 7 were excluded after a number of driving lessons, and another 2 withdrew on their own initiative. Conclusion: This is the first study in Europe to prepare subjects with reduced visual acuity to drive with the use of a bioptic telescope system. About 55% of the preselected subjects fulfilled all inclusion criteria. Half of the subjects who entered the bioptic training program passed the official fitness to drive test, demonstrating that they could drive smoothly and safely in Dutch traffic using a bioptic telescope system. INTODUCTIONWithout a doubt, vision is crucial for the complex task of driving a motor vehicle and constitutes the main input of information to the driver. Reduction of visual function can limit the ability to drive a car safely and, for this reason, official minimum requirements regarding the visual capacity of

Driving with Bioptic Telescopes

“…17,18,20,21,28,29,31,54,55 However, none of these articles are formal outcome evaluations that address the efficacy or comparative effectiveness of bioptic driver training approaches (with one exception discussed below 56 ). Thus, even though the described programs sometimes report that they have led to “successes” (i.e., visually impaired drivers who become licensed), we know little about which approaches are cost-effective, are the most successful in terms of number of drivers eventually licensed, and facilitate the highest level of driver safety and performance.…”

“…Going back to the 1970s there has been sporadic discussion in the literature about various topics related to bioptic driving (for example, 17–31 ), including descriptions of how to prescribe bioptic telescopes, training programs for bioptic drivers, various state laws governing bioptic driving, and the appropriateness of such laws. In spite of the attention this topic has received, there has been very little rigorous scientific research on bioptic driving.…”

Methods for Automated Identification of Informative Behaviors in Natural Bioptic Driving

“…In growing jurisdictions, now including at least 40 US states, the Netherlands [1, 2] and Quebec, Canada, people with moderate vision loss (usually corrected visual acuity between 20/40 and 20/200) may be licensed to drive with bioptic telescopes. In 21 US states, it is even possible for older drivers with age related vision loss to renew their driving license simply by passing the vision test with the telescopes, whereas the other 19 states require a road test with the telescopes [3].…”

Telescope Aiming Point Tracking Method for Bioptic Driving Surveillance

“…Although it is a legal option, whether the use of bioptic telescopes results in better (or worse) driving performance remains controversial [4, 5]. Both proponents and opponents agree the bioptic has optical limitations; one of which is an optically-induced ring scotoma.…”