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Home » Conferences » Keep Your Eyes on the Road: Vision’s Role in Driving

Keep Your Eyes on the Road: Vision’s Role in Driving

COVD3

Vision Guidelines

Over the past few years the COA Low Vision Committee has been working intensely with the Colorado Division of Motor Vehicles (DMV) to redefine the guidelines for driving and vision.

A motor vehicle customer who fails the central vision test of 20/40 will be given the DR2401 form (also available at http://www.revenue.state.co.us/MV_dir/wrap.asp?incl=dsforms) and told to see an eye care professional. Most DMV offices require the form to be signed within 30 days of the eye examination. If a patient is seen in your office after failing the DMV screening, the COA Low Vision Committee suggests the following.

 

Best Visual Acuity:

Best Eye, Best Corrected Vision

Recommendation

Suggested Restrictions

Other Considerations
20/40 or better Pass None None
20/50 to better than 20/100 Restrict & Educate
  • Daylight driving only
  • Left and Right side mirrors
  • If the patient has additional vision problems (i.e., visual fields, glare, scanning issues) consider adding mileage and rate of speed restrictions.
  • Consider referral/fitting for bioptic** telescope fitting and training.
  • Driver’s training with an OTR/CDRS*
  • Behind the wheel test by DMV
20/100 up to (but not including) 20/200 Restrict & Educate
  • All of the above
  • Additional restrictions in area (radius in miles from home) and rate of speed.
  • Consider referral/fitting for bioptic** telescope fitting and training.
  • Driver’s training with an OTR/CDRS*
  • Behind the wheel driving test by DMV
20/200 or worse Fail & Educate
  • Legal Blindness
  • No driving privilege should be granted under any circumstance.
  • Explore and/or refer for alternative forms of transportation.
  • Write letter for patient declaring legal blind eligibility.

*OTR/CDRS = Registered Occupational Therapist Certified Driving Rehabilitation Specialist. For a listing, go to http://www.driver-ed.organd click on “CDRS Directory”

**Visual acuity of 20/40 or better required with bioptic lenses.

Like all screening tests from the DMV, the eye care practitioner is advised to use his/her professional judgment in determining the safety of a visually impaired driver. It is highly recommended to have a patient evaluated “behind the wheel” by an OTR/CDRS or by the DMV if there are concerns as to the patient’s physical and cognitive abilities. If you have questions or are uncomfortable evaluating a patient for driving, consider referring your patient to a colleague who specializes in low vision. You can find a current listing of COAlow vision providers on the COAwebsite after logging into the Member’s Center at visioncare.org/_member_center/ccvip.php.

Course Questions/Answers:If a patient does not pass the CO vision requirements (20/40 in one eye), what is the appropriate way to handle this situation? Are we prevented by HIPPA to report or are we required ethically to report? Are we protected from liability if we advise the patient that they are not legally able to drive? Do we need to document that they drove home against medical advice, Other?

If a person does not have 20/40 vision, they can still drive with a RESTRICTED license if their form is signed off by a doctor. See the above low vision guidelines form from the COA website.

You are not required to report to the DMV if a patient is driving against your advice, just document well in the chart.

Regarding liability and the driver’s license form, the department of motor vehicle’s DR2401 form says:

NOTE: As provided by law, licensed physicians and optometrist are immune from civil and criminal action if they act in good faith and without malice 42-2-112 C.R.S.

Keep Your Eyes on the Road

Vision’s Role in Driving

Dr. Jen Simonson

Learning Objectives:

  1. Determine if a vision problem is affecting driving ability.
  2. Train on appropriate pre-testing to assist the doctor during the examination
  3. Learn how to select frames and lenses for improved driving performance.
  4. Learn how to communicate your patients on the visual skills needed for driving and the legal requirements for the state of Colorado.

Description: This course covers recommended testing for patients having difficulties with driving: acuity, contrast sensitivity, depth perception, and peripheral vision. It will cover the education of patients of the visual requirements for driving in the state of Colorado and lens product recommendations.

Vision’s Role on the Road

  • Driving TAKES Seeing
  • Ninety percent of driving decisions are based on what you see – or what you fail to see!
  • Highway safety demands that you see clearly, efficiently, and comfortably.

What Visual Skills Do You Need?

1. Clear Vision – (Visual Acuity)

Sight vs. Vision

  • Sight is the ability to see an object clearly
  • Vision is the ability to relate what has been seen to all senses and past experiences

– Fortunately, 94% of people who fail their drivers licensing vision test just need a pair of glasses to pass.

– Unfortunately, just because you can read the small letters on the eye chart doesn’t mean you have all of the visual skills needed for safe driving.

2. Depth Perception – the ability to judge relative distances between objects or an object and yourself.

3. Peripheral Vision – You must be aware of your side vision. Utilizing your side and rear view mirrors and turning your head from side to side helps you be better aware of what is around you.

4. Night Vision — The ability to see under low illumination and in the presence of glare.

Nearly 60% of all fatal traffic accidents occur at night (even though that is when there are fewer drivers and pedestrians)

5. Eye Coordination — When the eyes work together so that you do not see double vision, get tired quickly, or have poor visual reaction time.

6. Color Vision — The ability to recognize colors. Color deficient drivers can learn to distinguish signal lights by their location and by brightness differences.

7. Contrast Sensitivity — This is the ability to see objects even when they don’t stand out against the background. This skill is very important on rainy or snowy days.

Open Your Eyes to Vision on the Road

Street Signs

  • Traffic Lights
  • Landmarks
  • Maps
  • Directions
  • Obstacles
  • Road Conditions
  • Other drivers

Drivers License Vision Laws in Colorado By Douglas Christian Larsen

Passing the Exam

  • To pass the vision exam without glasses or contact lenses, an applicant must have 20/40 vision in at least one eye. As reported on the MD Support website for state vision requirements, applicants for a driver’s license are also tested for double vision, also known as “phoria.”

Corrective Lenses

  • An applicant may wear glasses or contact lenses when taking the vision examination but will be required to wear the lenses whenever operating a motor vehicle, and this will be noted on the final driver’s license as: “Rest. V.” To pass the examination while wearing lenses, 20/40 vision in at least one eye is required.

Colorado Age Considerations

  • As stipulated on the DMV.com website, when a Colorado driver turns 60 years of age, his driver’s license must be renewed every five years, with a vision examination included as part of the renewal process. As with all other instances, 20/40 vision is the common denominator for vision requirements. After the age of 60, the driver’s license cannot be renewed online or by mail.

Form DR 2401

  • If a driver fails the vision examination, a Confidential Medical/Eye Exam Report (DR 2401) will be issued and must be completed by the applicant’s eye-care specialist. The doctor must fully complete all vision-related portions of the form, and may also stipulate whether or not driving is prudent for the applicant. The doctor may also stipulate whether or not an applicant should be restricted to daylight driving, or only up to a certain speed, or within a certain radius of the applicant’s home.

Bioptic Telescope

  • Bioptic telescope lenses are allowed under Colorado law, but the full vision apparatus must be worn during the driving portion of the test. A Form DR 2401 must also be supplied by the individual’s vision-care specialist. During the visual examination, the applicant must wear only the “carrier” lens without the telescope portion attached.

Read more: Drivers License Vision Laws in Colorado | eHow.comhttp://www.ehow.com/list_6157223_drivers-license-vision-laws-colorado.html#ixzz19WAUSBoL

Changes in Vision often happen so slowly, that they go unnoticed.

  • You should have your eyes examined every 1-2 years.
  • If you are having problems, go in early! Don’t put yourself at risk for an accident!

Vision is comprised of:

  • Eye health
  • Clarity of sight at distance and near
  • Eye teaming coordination
  • Eye movement control (tracking and fixation)
  • Visual perception (including visual memory, visual discrimination, figure-ground, visual closure, directionality, etc.)

SAFETY TIPS

  1. KEEP YOUR EYEGLASSES UP-TO-DATE.
  2. WEAR SUNGLASSES WITH UV PROTECTION.
  3. USE YOUR MIRRORS.
  4. ADJUST YOUR SEAT SO THAT YOU CAN SEE EASILY.
  5. KEEP YOUR WINDOWS, MIRRORS, HEADLIGHTS, AND TAIL LIGHTS CLEAN AND IN GOOD REPAIR.
  6. AVOID DRIVING AT NIGHT IN UNFAMILIAR AREAS OR IN BAD WEATHER.
  7. MINIMIZE DISTRACTIONS IN THE CAR.
  8. DO NOT DRIVE IF YOU ARE DROWSY.

Driving Tips:

  1. Driving takes attention – in a split second you may need to react. Your eyes must look for warnings from the front, side, and back.
  2. Driving takes proficiency
  3. You need to know where the blind spots are in your car.
  4. You need to travel at a reasonable speed.
  5. You need to avoid medications and drugs that impair your driving ability.

Colorado

 

Driver licensing agency
contact information
Colorado Department of Motor Vehicles
Driver License Administration
1881 Pierce Street, Room 136
Lakewood, CO 80214
www.mv.state.co.us/mv.html
303 205-5646
Licensing 1

Visual acuity

Visual fields
Color vision requirement
Restricted licenses

Each eye with/without correction
Both eyes with/without correction
If one eye blind—other with/without correction
Absolute visual acuity minimumAre bioptic telescopes allowed?
Minimum field requirement
None**
Available based on doctor’s recommendations
20/40*
20/40
20/40
No absolute minimum acuity. The DMV will license any individual whom a physician/optometrist feels is not a danger.
Yes
None**
Licensing 2

Standard

Age-based renewal procedures

Length of license validation
Renewal options and conditions
Vision testing required at time of renewal?
Written test required?Road test required?At age 61, renewal period is reduced to every 5 years; no renewal by mail at age 66+.
10 years
If eligible, mail-in every other cycle
Yes, at in-person renewal
Only if point accumulation results
in suspension
No, unless condition has developed since last renewal that warrants
road test.
Reporting

Physician/medical reporting

Immunity
Legal protection

DMV follow-up

Other reporting
Anonymity

Drivers should self-report medical conditions that may cause a lapse of consciousness, seizures, etc. Physicians are encouraged but not required to report patients who have a medical condition that may affect their ability to safely operate a motor vehicle.
N/A
No civil or criminal action may be brought against a physician or optometrist licensed to
practice in Colorado for providing a written medical or optometric opinion.
The driver is notified in writing of the referral and undergoes a re-examination. Medical clearance may be required from a physician, and restrictions may be added to the license.
Will accept information from courts, police, other DMVs, and family members.
Not anonymous or confidential

* Unless the customer is blind in one eye, individual eye acuity is not normally tested nor is there an individual eye minimum acuity requirement. The DMV is concerned with the acuity of both eyes together, unless the applicant is applying for a Commercial Driver’s License.

** Based on discussions with ophthalmologists and optometrists, the DMV does not currently test peripheral vision or color vision as accommodations can be made for these deficiencies. However, testing is performed for phoria.

http://www.nhtsa.gov/people/injury/olddrive/OlderDriversBook/pages/Colorado.html

Colorado

All original and renewing applicants must take and pass a vision test. To pass the acuity test, applicants must have at least 20/40 vision in either or both eyes. Drivers are also screened for phoria (double vision), unless they have vision in only one eye. Applicants using bioptic telescopic lenses must attempt to pass the acuity test using only the carrier lens (and not the telescope). Drivers who fail the acuity or the phoria test must have a Confidential Medical/Eye Exam Report (DR 2401) completed by their vision specialist. The vision specialist is required to complete all sections pertaining to vision, indicate whether authorizing a driving privilege would be medically prudent, and recommend licensing restrictions that should apply. The eye specialist may check off any of the following restrictions, or enter a restriction not on the list: daylight driving only; not more than ___ mph; area radius ___ miles from home; right sideview mirror, or left sideview mirror. Bioptic lens users must also pass a drive test using the telescopic lens apparatus.

http://www.mdsupport.org/library/drivingrequirements.html#Colorado