Views and practices of Australian optometrists regarding driving for patients with central visual impairment

Abstract

Background Eye‐care practitioners are often required to make recommendations regarding their patients' visual fitness for driving, including patients with visual impairment. This study aimed to understand the perspectives and management strategies adopted by optometrists regarding driving for their patients with central visual impairment. Method Optometrists were invited to participate in an online survey (from April to June 2012). Items were designed to explore the views and practices adopted by optometrists regarding driving for patients with central visual impairment (visual acuity [VA] poorer than 6/12, normal visual fields, cognitive and physical health), including conditional driver's licences and bioptic telescopes. Closed‐ and open‐ended questions were used. Results The response rate was 14 per cent (n = 300 valid responses were received). Most respondents (83 per cent) reported that they advised their patients with visual impairment to ‘always’ or ‘sometimes’ stop driving. Most were confident in interpreting the visual licensing standards (78 per cent) and advising on legal responsibilities concerning driving (99 per cent). Respondents were familiar with VA requirements for unconditional licensing (98 per cent); however, the median response VA of 6/15 as the poorest VA suggested for conditional licences differed from international practice and Australian medical guidelines released a month prior to the survey's launch. Few respondents reported prescribing bioptic telescopes (two per cent). While 97 per cent of respondents stated that they discussed conditional licences with their patients with visual impairment, relatively few (28 per cent) reported having completed conditional licence applications for such individuals in the previous year. Those who had completed applications were more experienced in years of practice (p = 0.02) and spent more time practising in rural locations (p = 0.03) than those who had not. Conclusion The majority of Australian optometrists were receptive to the possibilities of driving options for individuals with central visual impairment, although management approaches varied with respect to conditional licensing.

Standardising the cataract referral process for public hospitals: perspectives of optometrists in New South Wales, Australia

“…Given the voluntary nature of participation, there is also some risk of response bias given that those who did respond may have had a particular interest in cataract surgical services. The response rate, while low (13 per cent), limiting the generalisability of the results from this sampled population, is consistent with previous studies using online surveys …”

“…The response rate, while low (13 per cent), limiting the generalisability of the results from this sampled population, is consistent with previous studies using online surveys. 16,17 From the list of 25 items sourced from the cataract referral template used in the UK 13,14 and criteria considered for cataract surgery prioritisation tools, 7,8 respondents tended to support items that are already routinely collected during an optometric eye examination. These items are distance visual acuity, ocular comorbidities, date of refraction, refraction, ocular medications, history of previous cataract surgery, requirement for translator, interest of patient in having cataract surgery, description of cataract, driving status, general medical history, allergies and reliance on driving for employment.…”

Bioptic Telescope Use in Naturalistic Driving by People with Visual Impairment

“…[2][3][4][5] However, those with moderately reduced visual acuity may be permitted to drive on a restricted license with the aid of a bioptic telescope in most states in the United States, 6,7 the province of Quebec in Canada, 8 the Netherlands, 9 and Australia. 10 The bioptic telescope is small and usually mounted at the top of the spectacle lens in front of one eye (Fig. 1).…”

Vision and driving: a look at the research road ahead

“…Other studies considered the potential role of conditional licensing for drivers waiting for cataract surgery, highlighting the fact that many drivers with cataracts on waiting lists for surgery would fail the visual acuity standards for driving. In another study, the management approaches adopted by optometrists in Australia, including the use of conditional licences was explored, demonstrating the diversity of approaches, which the authors suggest may arise due to the lack of strong research‐based evidence regarding driving safety in these populations.…”