The Road Begins Here – Part IV: The Eye Appointment

This article actually came at the request of some people in the albinism community.

Before we get started, you need to know your eye condition whether that be albinism or any other condition that may limit your vision. You need to have a basic understanding of how your eye condition limits your vision, and you’ll need to have a set of questions to ask your doctor that will clarify your vision limits. We’ll discuss this topic more below.

Traffic on the FDR drive during eh evening rush, with the Brooklyn Bridge in the background.

Your individual limitations will determine your eligibility to drive in your state and might even mean that you will have certain restrictions as you join the driving community. Keep this in mind: These restrictions are not meant to hold you back. They are meant to keep you and everyone around you safe while on the road.

So, you’re ready to approach your doctor about driving, but where do you start? You may have several questions and some anxiety to go along with them, but I’ll be clearing up some of the confusion and easing some of your anxieties.

Now, grab a glass of water, take a breath, and let’s work ahead of the curve.

Know Before You Go

Different states are going to have different requirements and criteria for bioptic driving. Before you approach your doctor about the possibility of driving, you should know your own state’s laws and requirements.

Vision Requirements

Photo by David Travis on Unsplash

Each state sets out a minimum visual acuity for driving, and these requirements sometimes include best corrected eye, visual field, and required bioptic training if a bioptic is permitted for driving in your state. A good place to start is the International Academy of Low Vision Specialists, Bioptic Driving USA, and, of course, your own state’s DMV website.

Here are some examples:

New York State

Where I live, New York’s bioptic driving requirements can be simplified to this:

  • Visual Acuity: minimum best corrected 20/40 in one eye with or without glasses;
  • 20/40 to 20/70 best corrected in one eye requires minimum of 140 degree horizontal visual field.
  • 20/80 to 20/100 best corrected in one eye requires minimum of 140 degree horizontal visual field plus 20/40 through a bioptic system.
  • Training in the use of the bioptic is mandatory.

Connecticut

The Danbury mall! Connecticut Scneice Center! The Merritt Parkway! New England autumns! Old money in Greenwich! The rows of food trucks in Hartford off of I-91! Being one state away from Family Guy! You get the picture. Here’s what you should expect:

Bioptic driving is not permitted in the state of Connecticut. “An operator’s license shall not be issued to an operator who uses spectacle mounted telescopic aids”. Health Standards for licensing decisions for operators of motor vehicles, section 14-45a-1

  • Visual Acuity: Unrestricted license, 20/40 in the better eye, with or without corrective lenses.
  • Restricted license, 20/50 to 20/70. In special circumstances a license can be issued when the visual acuity is 20/200.
  • Visual Field: Field of vision must be 140 degrees for a person with two eyes, 100 degrees for a person with one eye.

Required Forms

Each stay may also require an official form filled out by your eye doctor. That form should specify the type of physician who can fill it out as well. It’s important to take a copy of this form with you, so that your doctor visit can go as smoothly as possible.

For example, this form is required in New York state for those with vision between 20/40 and 20/70 or those who use telescopic lenses (bioptic lenses).

Tuck the words “periphery, preripheral, and, vision field into your pocket for now. This test is definitely an important one, and is actually pretty unique.

At the Doctor’s Office

You’ve thought about your limitations, and you’ve gathered your state’s driving regulations along with any forms you may need. Now, what do you ask the doctor?

First, you need to be sure you can meet your state’s basic requirements. Ask your doctor directly if you meet those vision requirements, and if you’re not there currently, are there steps you can take to get there (a better prescription or the possibility of a bioptic lens).

Be aware that not every doctor is informed on the use of bioptic lenses. You may need to see a specialist for further assessment. Chances are, if your vision is like mine, you’ll want to see the specialist.

When it comes to the actual evaluation, each part of it will help your eye doctor determine whether or not you fall within what your state requires to deem you a safe driver. Beyond the requirement though, this is where you really should consider having someone with you. Be it a parent, sibling, or a significant other, the only other person that will understand the gravity of what is going on in your head is someone that you’ve trusted with this. Moral support can go a long way. I wouldn’t know where I’d be without mine.

During The Exam

The first part of the evaluation was just like any other. I was asked about my current prescription and glasses. I was also asked about any changes in my vision. Just like any eye test, I was asked to read a chart at a distance – both in dark and nornal light – and had to have my pupils dilated. I absolutely cannot stand baving my pupils dilated. After those tests were done, I had some time to give my eyes a break.

The next stage of my evaluation was to test out how my vision would be improved by using a bioptic telescope. I ran through the same tests and charts as before, but things were so much clearer. With the telescope, I was able to read parts of the chart that I couldn’t read with my regular lenses. Of course, I had no idea how to interpret any of that. I just knew that I could see clearly.

The last part of the evaluation was something that I really did not anticipate. This was the vision field test. This helps your doctor gauge just how wide your periphery is and just how much you’re able to see at those angles. I was placed into a dimly lit room. My doctor placed my chin onto a chin rest that was connected to a device with a dome on it. Through the dome I could see some light, but it was opaque enough to still be dark.

The test went like this: the doctor would move a small dot of light into my field of vision against the opaque background of the dome. Each time I saw that light, I had to verbally acknowledge that I saw it. The light would appear at random points along the horizon of the dome, as well as slightly below and above my periphery. Think of it like hide and go seek without moving your eyes. Each acknowledgement was marked by my doctor on a chart, which showed where my peripheral vision limits were. After that test, I was finished.

Questions to ask after your test

It is so important to have a list of questions prepared before you visit the doctor, because once you’re in the office filled with anxiety (or excitement), you may forget something. I won’t be able to cover every single question that might be on your mind, but here’s a list that should get you on the right track:

  • Do you see any changes in my vision?
  • Do you anticipate that my license might have any restrictions against certain times of driving?
  • What can I do to compensate for the glare of oncoming headlights and sunlight?
  • What can I do to adapt my car to my own needs?
  • What is a bioptic telescope, and what type of bioptic telescope will help me? (Yes, even I asked this one.)

There aren’t any dumb questions when it comes to your vision. For the people in the back, THERE ARENT ANY DUMB QUESTIONS WHEN IT COMES TO YOUR VISION! Ask as many questions as you need to, and keep your doctor’s contact information handy.

Getting Your Bioptic

If you need to use a bioptic telescope, your doctor will show you some samples they may have on site. Otherwise, they may need to refer you to a low vision department or a third party who will be able to help you pick a bioptic to fit your needs. Do not be afraid to ask questions. These people are there to help you get out on the road safely.

When you first wear your bioptic, anticipate a period of having to get used to it. The best way I would recommend is to go on a few drives as a passenger, call shotgun (yes, we do that here in New York, too), and wear your bioptic. Practice using your carrier lens, then briefly switching to your telescope. Try reading a sign or two. Keep at it until you’re used to it. Remember, certain states mandate training on using your bioptic. You’ll want to find a driving school that specializes in that. Ask your local DMV or Vocational Rehabilitation office for help in finding a school that’s right for you.

Parting Words

When it comes to something we really want, we might sacrifice our own kindness to achieve that goal. I’ve done it to myself, especially whenever I suffered a setback. You begin to feel tired. You might even feel defeated. You might even feel like giving up. Don’t.

You’re human. It’s perfectly fine to feel tired. After a few setbacks, you’re going to feel weary, even defeated. Keep in mind, this is something that we were told that we wouldn’t ever be doing. Investments like these very rarely ever result in immediate returns. They often involve risk and a ridiculous amount of stress. They might even involve moments of disappointment. Live in those moments and feel what you’re feeling, but don’t let them dictate the pace at which you’re progressing forward. This is what your support system is for

When worse comes to worst, you may be in a state that might not allow bioptic driving, or you may not qualify to use a bioptic to drive. You might feel defeated. You might feel like you went through all of these tests for nothing. Push those thoughts out of your head. Your research, your questions, your desire to submit to eye evaluations, and even coming here, was all for one core reason – your independence. Take what I am about to say very seriously. Any investment into your future, regardless of return, or lack thereof, is never a waste of time. Moreover, there is still research being done all over the country. I became a bioptic driver at the age of 28. I was late to the party, too.

Stay tuned and follow from a safe distance. It’ll be worth the trip.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.