Implications of Vision Testing for Older Driver Licensing

Abstract

The functional attributes of vision currently assessed for licensing do not adequately explain unsafe driving performance. Differences were observed across vision requirements for the selected jurisdictions, possibly reflecting the equivocal and inconclusive findings linking specific visual functions and impairment with crash risk. Setting benchmarks or performance thresholds on selected visual tests may be problematic for older drivers in particular, who are most vulnerable to underperforming. Driving involves a complex set of skills, and it is proposed that decisions about vision for safe driving need to be considered in the context of the driver's overall health and other functional abilities.

Inequity in health: older rural driving and dementia

“…Road safety is an important component of a healthy community, and identifying drivers who pose an unacceptably high risk for crashes is a core responsibility of licensing authorities 21. In the absence of clear evidence to distinguish safe and unsafe drivers with dementia, the responsibility to make this distinction falls upon the treating doctor.…”

“…There is, in fact, no validated ‘doctor's room’ or ‘across-the-desk’ tool that reliably distinguishes between safe and unsafe drivers 20. This along with the progressive nature of dementia and the significant variation in the capacity of individuals to compensate for disabilities21 22 make assessment of fitness to drive a challenging task.…”

Aging Population and Driver Licensing: A Policy Perspective

“…Bohensky et al (2008) note that there is strong interaction between visual deficits and other conditions that affect elderly driving competence. Higgins, Wood, and Tait (1996) conclude that changes in driving performance could be predicted by a combination of measures of visual function, which include motion and peripheral sensitivity.…”

Helmets Matter: Kentucky Motorcycle Crash Victims Seen at a Tennessee Trauma Center

“…No data are available on the number of potentially impaired drivers identified through these practices or on the effects of more frequent renewals and vision tests on crashes. Furthermore, studies regarding the effectiveness of vision screening for license renewal indicate that the value of the vision tests commonly used for licensing decisions as predictors of increased crash risk is inconclusive and that the aspects of vision currently assessed for licensing do not adequately explain unsafe driving (Bohensky, Charlton, Odell, & Keefe, 2008). Nonetheless, one study found that fatalities among drivers 80 years and older in Florida decreased by 17% after the State passed a law requiring these drivers to pass a vision test before renewing their driver licenses (McGwin, Sarrels, Griffin, Owsley & Rue, 2008).…”