Visual Deficits

Clinician’s Guide to Assessing and Counseling Older Drivers, 3rd Edition, “Vision is the primary sense utilized in driving, and is responsible for 95% of driving related inputs.” Your vision can be affected by a number of diseases, as well as aging. There are many aspects of vision that need to be considered for driving, including: acuity, visual fields, and perception.*

• Visual Acuity/Low Vision: Visual acuity can be affected by a number of eye diseases and genetic conditions. Corrected (i.e. wearing glasses or contacts) visual acuity less than 20/40 may impact driving and will likely trigger a medical review by the state.

Some states, including Virginia, will consider the use of a bioptic lens system for low-vision driving. Discuss your options with your eye care professional.  Also take time to research the laws governing low-vision drivers in your state.

• Cataracts: Cataracts are the clouding of the eye lens.  Most are due to aging and are common in older people. According to the National Eye Institute, “By age 80, more than half of all Americans either have a cataract or have had cataract surgery.”

Cataracts cause the lens to be cloudy. Symptoms of cataracts while driving include:

• Objects looking blurry
• Problems with glare recovery (i.e. due to oncoming headlights and light reflected by rain)
• Poor night vision
• Possible double vision

If any of the above symptoms are affecting your driving ability, be sure to have a conversation with your eye care professional regarding possible medical interventions. You might also consider evaluation from a driving rehab specialist. Auto adaptive equipment and/or techniques may be recommended to increase function and safety.

• Diabetic Retinopathy: See section on Diabetes

• Macular Degeneration: Macular degeneration blurs your central vision, which is needed for “straight-ahead” activities (including driving). The loss of central vision can interfere with safe driving. Difficulty seeing road signs, traffic, and pedestrians might mean that macular degeneration is affecting your ability to drive safely.

Talk to your eye care professional about driving. You might also consider evaluation from a driving rehab specialist. Auto adaptive equipment and/or techniques may be recommended to increase function and safety.

Visual Fields: Visual fields can be affected by a number of conditions, including hemianopia and quadrantanopia, which can occur following a stroke or brain injury. Both occur when the optic tract or the occipital lobe of your brain is damaged. The amount and location of the visual field loss will determine if you are a candidate for return to driving.**