"In the depth of winter I finally learned that within me there lay an invincible summer."
- Albert Camus (1913-1960) French novelist
Who is a Candidate for Bioptic Driving?
Bioptic driving can be prescribed over a range of diseases and conditions.
Visual Acuity: The basic candidates are patients with mild to moderate central vision loss from a range of 20/60-20/200.
Visual Field: Candidates must have "adequate" peripheral vision. However, there are no scientific studies that define how much visual fields is adequate for driving with bioptics. Most states require a wide peripheral visual fields. Indiana requires 120 degrees horizontally.
Color Vision: The ability to discriminate traffic signals and street signs is important. Bioptic drivers must be able to see brake lights and traffic lights. While many eye conditions affect color vision, there are only a small number of conditions that profoundly effect color vision, such as Achromatopsia and other Cone Dystrophies. We can help some of these patients discriminate traffic signals by using subtraction and enhancing filters These methods are discussed in our "Complex Cases" section under Achromatopsia.
Good Conditions for Bioptic Driving: The conditions we encounter that are generally favorable candidates for bioptic driving are albinism, macular holes or pucker, mild dry macular degeneration, mild juvenile macular dystrophies such as the early stages of Stargardt’s disease, Best’s disease, mild optic atrophy, and moderate Histoplasmosis maculopathy. Conditions should be reasonably stable.
Poor Conditions for Bioptic Driving: Poor candidates are patients with diseases like retinitis pigmentosa, severe glaucoma, severe macular degeneration and severe ischemic optic neuropathies. All of these conditions have in common much more severe impairments of visual fields. Some will have severely impaired visual acuity.
Case-by-Case Decision: Each patient should be looked at on an individual basis despite their eye condition. For example, diabetic patients can fit into any category depending on the severity of the disease. Some patients have no retinal damage while others have severe diabetic retinopathy.
Physical or Cognitive Problems: Patients must have adequate congnitive ability and no physical problems that would preclude safe driving. One example might be a seizure disorder that is not adequately controlled or a senior driver with early dementia.
The Low Vision Centers of Indiana
Richard L. Windsor O.D., F.A.A.O., D.P.N.A.P.
Craig Allen Ford O.D., F.A.A.O.
Laura Kathleen Windsor. O.D., F.A.A.O.