Academic journal article Journal of Visual Impairment & Blindness

Driving and Low Vision: An Evidence-Based Review of Rehabilitation

Academic journal article Journal of Visual Impairment & Blindness

Driving and Low Vision: An Evidence-Based Review of Rehabilitation

Article excerpt

Abstract: This systematic review of the effectiveness of driver rehabilitation interventions found that driver training programs enhance driving skills and awareness, but further research is needed to determine their effectiveness in improving driving performance of drivers with low vision. More research is also needed to determine the effectiveness of low vision devices for driving.


Individuals with vision loss find that the retention of driving abilities and privileges is important for leading productive and meaningful lives. Low vision rehabilitation programs that focus primarily on driver education and retraining are possible options for those who want to improve and maintain their driving skills. Driving performance may be impaired in individuals with vision loss for a number of reasons, including age-related eye disease or as a result of recovery from a stroke or other neurological event. The main objectives of this review are to present findings and formulate conclusions, based on a comprehensive search for the best evidence related to driving with low vision and the effectiveness of training-education programs and assistive technologies for driver rehabilitation.

Effectiveness of interventions to improve driving


Because of the high crash rates and controversies surrounding the licensing of drivers who are elderly and visually impaired, some agencies have developed and instituted driver retraining programs in clinical rehabilitation settings or at the agencies themselves (Owsley, McGwin, Phillips, McNeal, & Stalvey, 2004; Salzberg & Moffat, 1998). Driver training programs provide classroom-type materials, such as videos or books, but may also include on-road or simulator-based driving assessments. The effectiveness of these programs for reducing crash rates has yet to be determined (Owsley et al., 2004), but within the spectrum of rehabilitation services, driver education and retraining certainly has the potential to benefit individuals with vision loss.


Low vision devices can be used to improve the visual performance of drivers with visual impairments, including their ability to read road signs, to see distant objects, and to visualize objects within the driving environment. Bioptic telescopes are miniature telescopes that are typically monocular and mounted at the top of a carrier lens above the wearer's line of sight. They are engaged by dropping the chin slightly to reposition the telescope optics into the line of sight, so the wearer can read road signs, visualize traffic lights, and spot possible traffic hazards. The use of bioptics while driving is allowed in some jurisdictions in North America, but the research evidence related to the strength of the effectiveness of using low vision devices while driving--or the licensing requirements surrounding their use-has not been well developed to date (Peli, 2002). Mirrors and binocular sector prisms have been advocated by low vision practitioners for individuals with hemianopia, which is the loss of half the visual field in both eyes. Many states in the United States allow individuals with hemianopia to continue to drive, upon completion of specific driving and vision evaluations (Peli, 2002).


We sought to answer the following main question with this research synthesis: What is the evidence that rehabilitative interventions are effective for improving the driving skills and performance of individuals with low vision, including those who have low vision or a hemianopic field loss as the result of a stroke?


A search of the literature was conducted to locate studies related to the term low vision and various visual impairment conditions, as well as the terms rehabilitation, training, assistive technologies (low vision devices or strategies) and driving, based on methods and criteria outlined in the report on which this review was based (Strong, Jutai, Hooper, Russell-Minda, & Evans, 2007). …

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