Ophthalmology and Visual Sciences

  • Driving with a Visual Impairment

    Mark E. Wilkinson, O.D.
    Director, Vision Rehabilitation Service
    UIHC Department of Ophthalmology and Visual Sciences

    Almost daily, individuals with visual impairments confront eye care professionals with questions concerning operating a motor vehicle. These individuals fall into three categories:

    • Teenagers with congenital or acquired visual impairment
    • Adults with congenital or acquired visual impairment who have never driven
    • Adults with acquired visual impairment who will become non-drivers because of decreased visual acuity

    Visual Field/Visual Acuity Standards for Driving

    Illlinois | Iowa | Missouri | Minnesota | Nebraska | South Dakota | Wisconsin | Additional Information


    Illinois

    Visual Acuity:     Restrictions (if any) 
    > 20/40 in one or both eyes  No restrictions 
    20/41 - 20/70 in one or both eyes  No driving when headlights are required 
    20/71 - 20/100 in one or both eyes  Bioptic telescope required unless living in a town with a population of 3000 or less 

        - Must achieve 20/40 or better with no
          more than a 3x telescope 
        - Requires a vision specialist statement
          indicating the individual has had the
          telescope a minimum of 60 days and
          has been trained to use the telescope
          when driving
        - Requires a behind the wheel test
        - Must be approved by a medical review
          board 
        - No night driving allowed with a
         bioptic telescope
    < 20/100 in one or both eyes  License denied 

     

    Visual Field (uninterrupted is not specified): Restrictions (if any)
    > 140 degrees binocular or monocular No restrictions
    139 - 105 degrees binocular with at least one eye having a monocular field of at least 70 degrees temporal and 35 degrees nasal Vehicle must have left and right outside mirrors
    < 105 binocular or monocular field License denied


    Illinois uses a vision standard for driving. This standard states that it is the individual’s legal responsibility to notify the Illinois Secretary of State’s office within 10 days of becoming aware that they have reduced visual acuity or visual field limitations that may disqualify them from further driving.

    For additional information or to print a copy of the driving form:
    http://www.dmv.org/il-illinois/disabled-drivers.php#Vision-Impairments  

    Iowa

    Visual Acuity: Restrictions (if any)
    ≥ 20/40 in one or both eyes No restrictions
    20/41 - 20/71 in one or both eyes No driving when headlights are required

        -Behind the wheel testing can
          be requested via discretionary
          review process to gain privilege
          to drive when headlights are
          required.
    20/71 - 20/199 Discretionary issuance 

        -Requires a vision specialist
          statement indicating
          the individual is visually
          competent to drive
        -Requires a behind the wheel test
        -The behind the wheel testing is
          used to determine maximum
          speed, distance from home
          and whether ok to drive when
          headlights are required
        -If VA < 20/100, must also be,
          approved by a medical
          review board
        -If VA is <20/100 in the left eye,
          will be required to have a left
          and right outside mirror
    ≤ 20/200 License denied

    Bioptic Telescopes: Not allowed to achieve the visual acuity standards noted above

    Visual Field (uninterrupted is not specified) Restrictions (if any)
    ≥ 140 degrees binocular No restrictions
    < 140 degrees but ≥110 degrees binocular or
    ≥100 degrees monocular
    Vehicle must have left and right outside mirrors
    <110 degrees binocular or <100 degrees monocular, but ≥75 degrees monocular or binocular
    Discretionary issuance

        -Requires a vision specialist
          statement indicating the
          individual is visually
          competent to drive
        -Requires a behind the wheel
          test
    <75 degrees binocular or monocular Discretionary issuance

        -Requires a vision specialist
          statement indicating the
          individual is visually
          competent to drive
        -Requires a behind the wheel
          test
        -Must also be approved by a
          medical review board
    <20 degrees binocular or monocular License denied

    Iowa uses a vision standard for licensure. This standard states that the individual is legally qualified to drive, until their license comes up for renewal, regardless of whether their visual acuity or visual field becomes impaired during the interval between licensing renewal. Although individuals with acquired visual impairments are legally qualified to drive until their license is up for renewal, civil liability exposure exists if they continue to drive with the knowledge that they would no longer visually qualify to drive, if they attempted to renew their license. If the Iowa Department of Transportation becomes aware that a person has experienced a decrease in their visual acuity or visual field, the DOT will arrange for a re-evaluation to see if the person is capable of continuing to safely operate a motor vehicle.

    For additional information: http://www.iamvd.com/ods/  

    To print a copy of the driving form:
    https://forms.iowadot.gov/BrowseForms.aspx?category=2  

    Iowa Dark Window Exemption

    Effective July 4, 2012
    ADMINISTRATIVE RULE 761-450.7(3)

    The dark window exemptions will no longer be granted from the minimum standard of transparency. A motor vehicle fitted with a front windshield, a front side window or a front side wing window with less than 70 percent but not less than 35 percent light transmittance before July 4, 2012, may continue to be maintained and operated after July 4, 2012, so long as the vehicle continues to be used for the transport of a passenger or operator and the dark window exemption which documented a medical need for such reduced transparency, was signed by the person’s physician before July 4, 2012. The exemption must be carried at all times in the vehicle to which it applies. At such time the vehicle is no longer used for the transport of the passenger or operator that is the subject of the exemption, the exemption expires and may not be used on any replacement vehicle purchased after July 3, 2012. The owner of the vehicle to which the exemption applied must return the vehicle to conformance with the minimum standard of transparency within 60 days of expiration of the exemption.  

    Missouri

    Visual Acuity: Restrictions (if any)
    > 20/40 in one or both eyes No restrictions
    20/41 - 20/160 Discretionary issuance
    < 20/160 in one or both eyes License denied

    Bioptic Telescopes: Not allowed to achieve the visual acuity standards noted above

    Visual Field: (uninterrupted is not specified) Restrictions (if any)
    >55 degrees in each eye or 85 degrees monocular No restrictions
    70 - 109 degrees binocular or monocular Discretionary issuance 
    <70 degrees binocular or monocular  License denied


    Missouri uses a vision standard for licensure. This standard states that the individual is legally qualified to drive, until their license comes up for renewal, regardless of whether their visual acuity or visual field becomes impaired during the interval between licensing renewal. Although individuals with acquired visual impairments are legally qualified to drive until their license is up for renewal, civil liability exposure exists, if they continue to drive with the knowledge that they would no longer visually qualify to drive, if they attempted to renew their license. If the Missouri Motor Vehicle Department becomes aware that a person has experienced a decrease in their visual acuity or visual field, the DOT will arrange for a re-evaluation to see if the person is capable of continuing to safely operate a motor vehicle.

    For additional information: http://www.dor.mo.gov/mvdl/drivers/dlguide/  

    To print a copy of the driving form: http://dor.mo.gov/forms/index.php?formName=&category=2&year=&searchForms=Search+Forms - choose form 999

    Minnesota

    Visual Acuity: Restrictions (if any)
    > 20/40 in one or both eyes No restrictions
    20/41 - 20/70 in one or both eyes Speed restrictions

    May also have time of day and radius from home restrictions
    20/71 - 20/99 in one or both eyes
    Discretionary issuance 

        -Requires a vision specialist statement
          indicating the individual is visually
          competent to drive
        -Requires a behind the wheel test
        -May have speed, time of day and radius
          from home restrictions
    < 20/100 License denied

    Bioptic Telescopes: Not allowed to achieve the visual acuity standards noted above

    Visual Field: (uninterrupted is not specified) Restrictions (if any)
    ≥ 105 degrees binocular or monocular No restrictions
    < 105 degrees binocular or monocular Discretionary issuance

        -Vehicle may require left and right
          outside mirrors, in addition to speed,
          radius from home and time of day
          restrictions
    < 100 degrees binocular or monocular License denied


    Minnesota uses a vision standard for driving. This standard states that it is the individual’s legal responsibility to notify the Minnesota Driver and Vehicle Services office when they becoming aware that they have reduced visual acuity or visual field limitations that may disqualify them from further driving.

    For additional information: http://www.dps.state.mn.us/dvs/  

    To print a copy of the driving form: https://dps.mn.gov/divisions/dvs/forms-documents/Pages/drivers-license-forms.aspx - select form PS30338

    Nebraska

    Visual Acuity:  Restrictions (if any) 
    ≥ 20/40 in one or both eyes  No restrictions 
    20/41 - 20/60 in one or both eyes  No driving when headlights are required 
    20/60 - 20/70 in one or both eyes  If blind in fellow eye, license will be denied 
    20/70 in one or both eyes  No driving when headlights are required and speed limitations 
    < 20/71 in one or both eyes  License denied 

    Bioptic Telescopes: Are allowed to achieve the visual acuity standards noted above

    Visual Field: (uninterrupted is specified)  Restrictions (if any) 
    ≥ 140 degrees  No restrictions 
    139 - 120 degrees  Vehicle must have left and right outside mirrors 
     100 119 degrees No driving when headlights are required 

        -Radius from home and speed
          limitations 
    < 100 degrees  License denied 

    Nebraska uses a vision standard for licensure. This standard states that the individual is legally qualified to drive, until their license comes up for renewal, regardless of whether their visual acuity or visual field becomes impaired during the interval between licensing renewal. Although individuals with acquired visual impairments are legally qualified to drive until their license is up for renewal, civil liability exposure exists, if they continue to drive with the knowledge that they would no longer visually qualify to drive, if they attempted to renew their license. If the Nebraska Department of Motor Vehicle becomes aware that a person has experienced a decrease in their visual acuity or visual field, the DOT will arrange for a re-evaluation to see if the person is capable of continuing to safely operate a motor vehicle.

    For additional information: http://www.dmv.state.ne.us/examining  

    To print a copy of the driving form: http://www.dmv.state.ne.us/examining/forms#vision

    South Dakota

    Visual Acuity:   Restrictions (if any) 
    > 20/40 in one or both eyes  No restrictions if fellow eye is at least 20/50 

        -If fellow eye less than 20/60, left and
          right outside mirrors required 
    20/41 - 20/60 in one or both eyes  Discretionary issuance 

        -Requires a vision specialist statement
          indicating the individual is visually
          competent to drive
        -May result in speed, time of day and
          radius from home restrictions 
    < 20/60 in one or both eyes  License denied 

    Bioptic Telescopes: Not allowed to achieve the visual acuity standards noted above

    Visual Field:

    • Not considered

    South Dakota uses a vision standard for licensure. This standard states that the individual is legally qualified to drive, until their license comes up for renewal, regardless of whether their visual acuity or visual field becomes impaired during the interval between licensing renewal. Although individuals with acquired visual impairments are legally qualified to drive until their license is up for renewal, civil liability exposure exists, if they continue to drive with the knowledge that they would no longer visually qualify to drive, if they attempted to renew their license. If the South Dakota Department of Public Safety becomes aware that a person has experienced a decrease in their visual acuity or visual field, the DOT will arrange for a re-evaluation to see if the person is capable of continuing to safely operate a motor vehicle.

    For additional information or to print a copy of the driving form: http://www.state.sd.us/dps/dl/Applications/main.asp  

    Wisconsin

    Visual Acuity:  Restrictions (if any) 
    > 20/40 in one or both eyes  No restrictions 
    20/41 - 20/100 in one or both eyes  Discretionary issuance 

        -Requires a vision specialist statement of
          visual acuity
        -May require a behind the wheel test
        -May result in speed, time of day and
          radius from home restrictions 
    < 20/100 in one or both eyes  License denied 

     

    Bioptic Telescopes: Not allowed to achieve the visual acuity standards noted above

    Visual Field: (uninterrupted is specified)  Restrictions (if any) 
    > 140 degrees binocular  No restrictions 
    139 - 40 degrees binocular or monocular  Discretionary issuance

        -Requires a vision specialist statement
          of visual field
        -May require a behind the wheel test
        -May result in speed, time of day and
          radius from home restrictions 
    < 40 degrees binocular or monocular  License denied 


    Wisconsin uses a vision standard for licensure. This standard states that the individual is legally qualified to drive, until their license comes up for renewal, regardless of whether their visual acuity or visual field becomes impaired during the interval between licensing renewal. Although individuals with acquired visual impairments are legally qualified to drive until their license is up for renewal, civil liability exposure exists, if they continue to drive with the knowledge that they would no longer visually qualify to drive, if they attempted to renew their license. If the Wisconsin Department of Transportation becomes aware that a person has experienced a decrease in their visual acuity or visual field, the DOT will arrange for a re-evaluation to see if the person is capable of continuing to safely operate a motor vehicle.

    For additional information or to print a copy of the driving form: http://www.dot.wisconsin.gov/drivers/drivers/apply/vision.htm


    Additional Information

    • The DOT does make accommodations for the functionally illiterate. An auditory, computer generated voice, test can be provided or the individual can bring someone with them to read the test.
    • As part of the author's work up, we ask the following questions. Do you drive? If yes, what type of driving do you do? Do problems with your sight cause you to be fearful when you are driving? During the past 6 months, have you made any driving errors? Is your driving ability affected by your vision?
    • For individuals that are visually impaired who wish to be licensed or to have the privileges of his or her license expanded, a letter from a vision specialist is required and must state, "It is my professional opinion that (patient name) has the visual ability to operate a motor vehicle". The author would also recommend that the letter state "I am requesting that a hearing officer provide (patient name) with a behind the wheel evaluation to see if he/she can acquire/maintain the privilege of operating a motor vehicle".
    • A letter can replace the Vision Specialist Form 430032 (Iowa) if all of the information from the departmental vision form is included. This information includes:
      *The patient's full name and address
      *Visual acuity OD, OS, and OU, both uncorrected, corrected,
      and with new prescription when appropriate.
      *The visual fields for the right and left eye measure nasally
      and temporally.
      *A statement concerning whether the eye specialist feels the
      individual is visually competent to drive
      *A statement concerning privileges, whether they be
      general, daylight only, or limited
      *If limited, the amount of limitations
      *Should vision be rechecked sooner than 2 years
      *The date of the examination, which needs to be within 30 days of the individual's attempt to be licensed or re-licensed.
    • The Iowa DOT does allows eye care practitioners (MD, DO and OD) to report to the department the identity of a person who has a physical or mental condition which may render that person incompetent to operate a motor vehicle safely. The physician is to make reasonable efforts to notify the person in writing of the nature and reason for the report to the DOT. The physician has no duty to make a report or to warn third parties. The reporting physician is immune from any liabilities, civil or criminal, which may otherwise be incurred or imposed as a result of the report.
    • The author feels it is important for the practitioner to counsel those individuals, whose vision has decreased significantly from the time they were licensed, about their increased potential for personal liability if they are involved in an accident. For those individuals whose vision changes after they are licensed, the author would recommend that they be re-evaluated by the DOT to see if they are still capable of continue to safely operate a motor vehicle. 

    This document updated July 12, 2012

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