title: Characteristics of on-road driving performance of persons with central vision loss who use bioptic telescopes.
abstract: OBJECTIVE
  To compare the on-road driving performance of visually impaired drivers using bioptic telescopes with age-matched controls.
  
  
  METHODS
  Participants included 23 persons (mean age = 33 ± 12 years) with visual acuity of 20/63 to 20/200 who were legally licensed to drive through a state bioptic driving program, and 23 visually normal age-matched controls (mean age = 33 ± 12 years). On-road driving was assessed in an instrumented dual-brake vehicle along 14.6 miles of city, suburban, and controlled-access highways. Two backseat evaluators independently rated driving performance using a standardized scoring system. Vehicle control was assessed through vehicle instrumentation and video recordings used to evaluate head movements, lane-keeping, pedestrian detection, and frequency of bioptic telescope use.
  
  
  RESULTS
  Ninety-six percent (22/23) of bioptic drivers and 100% (23/23) of controls were rated as safe to drive by the evaluators. There were no group differences for pedestrian detection, or ratings for scanning, speed, gap judgments, braking, indicator use, or obeying signs/signals. Bioptic drivers received worse ratings than controls for lane position and steering steadiness and had lower rates of correct sign and traffic signal recognition. Bioptic drivers made significantly more right head movements, drove more often over the right-hand lane marking, and exhibited more sudden braking than controls.
  
  
  CONCLUSIONS
  Drivers with central vision loss who are licensed to drive through a bioptic driving program can display proficient on-road driving skills. This raises questions regarding the validity of denying such drivers a license without the opportunity to train with a bioptic telescope and undergo on-road evaluation.
authors: School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia. j.wood@qut.edu.au
authors: Joanne M
authors: JM
authors: Wood
authors: Gerald
authors: G
authors: McGwin
authors: Jennifer
authors: J
authors: Elgin
authors: Karen
authors: K
authors: Searcey
authors: Cynthia
authors: C
authors: Owsley
mesh_terms: D000328:Adult; D000407:Alabama; D001334:Automobile Driving / Q000331:legislation & jurisprudence; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008004:Licensure; D008297:Male; D008875:Middle Aged; D012449:Safety; D061351:Telescopes; D014741:Video Recording; D015354:Vision, Low / Q000534:rehabilitation*; D014785:Vision, Ocular; D014792:Visual Acuity; D055815:Young Adult
keywords: bioptic telescopes; driving performance; on-road driving assessment; spotting
references: Invest Ophthalmol Vis Sci. 2009 Feb;50(2):577-85
references: 18936138
references: Am J Optom Arch Am Acad Optom. 1970 Aug;47(8):619-28
references: 5273102
references: Invest Ophthalmol Vis Sci. 2005 Jan;46(1):66-74
references: 15623756
references: Optom Vis Sci. 2012 Sep;89(9):1249-56
references: 22863791
references: J Gerontol A Biol Sci Med Sci. 1999 Apr;54(4):M203-11
references: 10219012
references: Assist Technol. 2012 Fall;24(3):184-95
references: 23033735
references: Ophthalmic Physiol Opt. 2011 May;31(3):318-25
references: 21410498
references: Arch Ophthalmol. 1983 Dec;101(12):1907-8
references: 6651597
references: J Am Geriatr Soc. 1997 Feb;45(2):202-6
references: 9033520
references: Nature. 1994 Jun 30;369(6483):742-4
references: 8008066
references: Invest Ophthalmol Vis Sci. 2011 Mar 02;52(3):1220-5
references: 21367969
references: Am J Ophthalmol. 2003 Feb;135(2):194-205
references: 12566024
references: Optom Vis Sci. 2008 Dec;85(12):1135-41
references: 19050468
references: J Am Optom Assoc. 1995 May;66(5):274-80
references: 7629367