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Driving with Bioptic Telescopes Independent Living ViewFinder Low Vision Resource Centers The eye doctors at the ViewFinder Low Vision Resource Centers specialize exclusively in Low Vision Rehabilitation. They have been recognized as leaders in low vision rehabilitation not only in Arizona, but throughout the United States. Our doctors help their patients enhance their remaining vision with special low vision eyeglasses and custom microscopic and telescopic low vision aids. They provide the latest, state-of-the art technology for our visually impaired patients. They also recommend other optical and non-optical low vision aids as well as low vision services to complete our patient’s total rehabilitation. With the help of our doctors, occupational therapists and staff, our patients will learn how to perform their daily tasks despite a visual impairment so that they can enjoy life and remain independent. To make an appointment for a low vision evaluation with one of our doctors, please call either ViewFinder location. Locations: 1830 South Alma School Road, Suite 131 • Mesa, Arizona 85210 • 480.924.8755 10001 West Bell Road, Suite 115 • Sun City, Arizona 85351 • 623.583.2800 Toll Free Number: 866.924.8755 www.ViewFinderLowVision.com 2 Driving and Visual Impairment The ability to drive is a privilege that many of us take for granted. Driving affects our quality of life and is a means to exercise freedom of mobility. The ability to drive gives people access to better jobs. It lets visually impaired parents share more fully in their children’s lives when they can attend school events. Driving also decreases the social isolation many visually impaired adults feel when they cannot leave their homes. Arizona is one of 41 states that will grant a driver’s license to some visually impaired people when they drive using a bioptic telescope. Driving with a visual impairment while using bioptic telescopes is a very personal decision and that decision should be made collaboratively by the individual, the low vision eye specialist and the motor vehicle department. Vision is not the only factor that should be taken into consideration. Cognitive ability, reaction time and use of good judgment are equally important. Your eye doctor will discuss these and other issues during your evaluation. Using information obtained from a functional low vision evaluation you and your eye doctor will determine if you are a candidate for the Bioptic Driving Program. 3 What are Bioptic Telescopes? Bioptic telescopes are miniature telescopes which are mounted into ophthalmic corrective lenses, usually above the person’s line of sight. The telescopes can be focusable or non-focusable and come in powers from 1.7X – 8X. The focusable telescopes usually focus from infinity to 12” making them useful for distance, intermediate and near tasks. Our patients use the telescopes not only for driving but also for seeing signs in the grocery store and airport, products on grocery store shelves, watching television and for seeing their computer monitor. Parking lot viewed Normally Parking lot viewed with a 3X Bioptic Telescope 4 How are Bioptic Telescopes Used for Driving? Mounting the bioptic telescope into the lens in a pair of eyeglasses allows the driver to use his regular prescription lenses as well as the telescope gaining first an overall view and then very detailed view of the road, traffic and signs up ahead. The Bioptic Telescopic System allows a trained user the opportunity to detect objects or movement within his/her driving scene using the wide field of view available through the regular spectacle lens and to resolve fine details such as road signs and traffic lights by glancing briefly and intermittently into and out of the miniature telescope. (See photo). The bioptic driver’s use of the telescope can be likened to the normally sighted driver’s use of rear and side mirrors. They are used as spotting tools for one or two seconds at a time. The telescopes come in a variety of sizes, styles and powers can be made in either focusable or non–focusable versions. They can contain the person’s eyeglass prescription and/or tints. The telescopes are focused at distance while driving. Your eye doctor will help you determine the best telescope for your needs. Driving with a bioptic telescope requires extensive training in the 5 general use of the telescope as well as behind-the-wheel driver’s training. The bioptic telescope is a prescriptive device, prescribed by either an optometrist or ophthalmologist specializing in low vision rehabilitation. If you are undecided as to whether you wish to pursue a bioptic driver’s license and would like to work with a telescope before making this decision, your eye doctor will have you work with a telescope during your routine low vision evaluation. We can even provide training with a hand held telescope so that you can view distance objects at home and while you are a passenger in a car. This may help you decide if bioptic driving is for you. Arizona Law Regarding the Use of Bioptic Telescopes While Driving The driver must be able to meet the current Arizona Department of Transportation visual acuity standards using no more than a 4X bioptic telescope. The current visual acuity standards state that a person will be granted a regular driver’s license with best corrected visual acuity of 20/40 or better. A person shall be restricted to daytime driving if they have a corrected visual acuity of 20/40 – 20/60. If a person cannot meet the acuity of 20/60, they will not be able to obtain a driver’s license. An eye doctor must determine the visual acuity of the driver and fill out an ADOT Driver’s Vision Form. The driver must have a visual field of at least 70 degrees temporally and 35 degrees nasally. Your eye doctor will determine the extent of your visual field with a visual field test. The driver must pass the standard driving test with an Arizona Department of Transportation driving instructor or our OT who specializes in Driving Rehabilitaion. The driver must demonstrate 6 that they can perform all regular driving tasks such as speed control, merging, driving in traffic and effective use of mirrors. The driver must have an ADOT Driver’s Vision form filled out by their eye doctor on an annual basis. Candidates for Bioptic Driving Low vision individuals with visual acuity 20/200 or better. No peripheral field defects. Stable ocular conditions, usually congenital. Albinism, aniridia and congenital nystagmus are examples. Some macular degeneration patients may be good candidates depending on the stability of the disease and eccentric viewing skills. Candidates must have the motor ability to scan a rapidly changing environment. Candidates must have sensory ability to perceive information in this rapidly changing environment. Candidates must have the attentiveness to process multiple pieces of information. Candidates must have the cognitive ability to judge this information in a timely fashion and to make appropriate decisions. Candidates must have the motor ability to execute these decisions in a timely fashion. 7 ViewFinder Bioptic Driving Program Steps to Becoming a Bioptic Driver Step # 1: A Functional Low Vision Evaluation: You will need a recent low vision examination performed by your low vision eye doctor. Your doctor will use the following tests to determine if you are a candidate for bioptic driving: 1. Visual Acuity Test 2. Visual Field Test The visual field test measures the total area in which objects can be seen in the peripheral vision while the eye is focused on a central point. 3. A dilated eye examination to rule out active pathology. 4. Contrast Sensitivity Test: A measurement of how well the eye sees in conditions that are not black and white. A truer measurement of how the eye sees in the real world. 5. Useful Field of View Test: The useful field of view (UFOV) test has been developed to access an individual's ability to process and react in a timely fashion to multiple visual events occurring simultaneously. It defines the visual field within which rapidly presented visual material can be used. The test includes processing speed, selective attention, and divided attention. Data shows that a reduction in the UFOV has been associated with increased future crash involvement, whereas a moderate reduction in visual acuity, contrast sensitivity, and visual field were not. Because the UFOV test relies on both visual sensory and cognitive skills, it provides a more global measure of visual functional status than either sensory or cognitive tests alone. 8 It is a good predictor of driving performance for patients and it is better than chronological age for identifying drivers at risk for crashes. Step #2: Designing and fitting your Bioptic Telescope: Bioptic telescopes are custom made for each patient and contain the patient’s unique prescription in the ophthalmic lenses and, in some cases, the telescope itself. Your eye doctor will determine the correct telescope for you. Your telescope may take up to 4 weeks to obtain from the manufacturer. Step #3: Training in the use of your Bioptic Telescope: A bioptic telescope alone does not make a person a safe driver. All potential drivers require extensive training in the use of their telescope. You will be evaluated and trained by ViewFinder’s occupational therapist. The evaluation will include a Useful Field of Vision test. The training will focus on the user’s ability to focus and demonstrate movement in and out of the bioptic within one to two seconds to spot distant targets. The goals are for the patient to be able to use the device effectively while stationary ( i.e., sitting or standing and spotting items across the room) and then while moving (i.e., walking in the grocery store, spotting signs and recognizing objects at a distance). Patients will also practice spotting targets while a passenger in their car with a friend or family member driving. The occupational therapist will instruct you through a series of exercises designed to bring you to a skill level ready to pursue driving. When you have demonstrated the ability to correctly use the bioptic telescope, your eye doctor may then recommend that you receive a Behind-the-Wheel Driver’s Evaluation before signing the vision form for your Arizona Driver’s license. Remember: Even if you hold a current license, you are not legal to drive with the bioptic telescope 9 until you have passed the Arizona Motor Vehicle’s Road Test. Step # 4: Driver Evaluation while Using the Bioptic Telescope: While Arizona does not require Behind-the-Wheel Training for potential bioptic drivers, your eye doctor may refer you to a driving rehabilitation program, especially if you have not driven in a period of time. Many lighting, glare and road conditions influence the ability of the low vision driver’s performance. A driving evaluation and training program will help prepare you for the Arizona Department of Transportation road test and increase your safety and confidence behind the wheel. The evaluation will be in two parts: the first part will be as a front seat passenger while the driving rehabilitation specialist drives. The patient will demonstrate their skills in spotting road signs and hazards. The second part will have the patient behind the wheel driving to demonstrate their skill using the Bioptic. The Driving Rehabilitation Specialist will make suggestions to help the patient with their driving skills and develop a training program to help the patient meet the Motor Vehicle department’s criteria to pass the drivers test while using the bioptic telescope. Patients who have never driven before will automatically be referred the Driving Rehabilitation program for driver’s training. You will be instructed in all aspects of driving to enable you to pass your on-theroad driving examination. 10