Driving Vision Tests

Your eye test for driving – We can assess driving standards relevant to private and commercial vehicles for acuity, peripheral vision and colour vision and ensure eye health.
To have a good chance of seeing an object whilst driving, we need to move our eyes, and probably head, to bring that object into the centre of our vision – so that we can use this high-resolution central capacity to resolve the detail.
When you move your head and eyes to scan a scene, your eyes employ quick jumps (called saccades) with very short pauses (called fixations) to integrate the vision we perceive.

Research shows us 60% of road accidents can be attributed to impaired vision. Distance vision has to be exact and comfortable, with adequate intermediate and peripheral vision required for driving. In all conditions, it is important to reduce the risks inherent in driving a car.

Practical Driving assessments
All drivers aged 85 years or older with an unrestricted licence must pass an on-road driving assessment every two years. Sometimes such a test may be required in other age groups as well for health reasons.
Conditional licences
RMS (NSW) or Access Canberra (ACT) will decide – if any – a conditional licence might be issued to a driver. Drivers aged 85 years or over have the option to be given a modified licence that operates within a certain radius of localities. A NSW Photocard can be issued instead of a returned or terminated drivers licence.

Safe Driving Vision

The task of car driving requires a licence application, multisensory integration, good health, visual acuity, peripheral vision, practical experience(per log book). The RTA requires a practical driving test for a learner driver or sometimes for licence renewal. The service centre’s testing officer or driving school can assess hazard perception and road rules. Optometry Australia’s 2020 Vision Index found 20 per cent of Australians between the ages of 35 and 54 find it difficult to read road signs. Specifically, 15 per cent of all Australians admit squinting to see while driving during the day while 59 per cent of all Australians are worried about the overall quality of their eyesight.
Legal vision requirements for driving are hard to enforce because of the difficulty in assessing people’s eyesight while they are in the car. Research has shown significant numbers of drivers do not meet vision requirements
Rather than Police officers asking drivers to read a road sign, mobile devices held up to a person’s forehead, showing illuminated letters, replicating the standard six-metre reading test done by optometrists are sometimes done. Drivers’ eyesight on the side of the road is not standardised.
There are enforcement issues as it is known large numbers of people admit to not wearing glasses to drive when they should.
There is a long period from when most people get their drivers licence to the time they finish driving, so regular eye tests are essential.
Some cars are even equipped with “eyesight” software to control braking and steering when collision potential arises
Drivers aged 65 and over represent large segments of all Australian road fatalities. Under new proposals, any driver could be obliged to undergo random roadside eyesight tests given vision impairment can affect people of all ages. Driver licences in most states nominate whether a driver should be wearing glasses. Police can check this during routine stops – there is no mechanism in place to catch people with failing eyesight, unless they need to repeat a vision test after losing their licence, or allowing it to lapse.
If you’re able to see 6/12 without glasses, then you won’t require a conditional licence. If you’re only able to see 6/12 or above with glasses, then the ‘S’ condition will be added to your licence. Generally speaking, you should be able to read a standard car licence plate from about 20 metres away. If you as an average person can see a road sign at 250m away, somebody who is not meeting the legal driving standard won’t see that sign until they are 100m away or closer. Reaction times are less as you are effectively driving above the speed limit. Sometimes, people outside the legal limit will be permitted to operate even with correctional lenses on. Still, only under certain conditions, for example, they can only go during daylight hours or within a specified radius of their home, but this is dependent on individual circumstances.
Some Australian states allow for self-declaration – otherwise, you have your vision checked when you’re 16 and getting your first licence, and then the next time in your 60s, 70s or 80s, depending on the state. In South Australia and the Northern Territory, optometrists report people driving with inappropriate vision to the transport authorities. In other states, it is not mandatory, but an optometrist can do it to promote road safety. Ideally, eye tests should occur for licence renewal, or every 1-2 years age depending on age. The penalties for driving in breach of licence condition S (visual aids required) vary from state to state.
Other conditions like glaucoma (which affects the side or peripheral vision) often do not have symptoms. So many cases are undiagnosed and suffering from this condition, as is the case with diabetes. People often can be blinded by the sun or dirty windscreens, so appropriate spectacle lenses and filters are required.
By day, wearing sunglasses also allows better vision by night because the rhodopsin chemical allowing dark adaption and better contrast sensitivity is not depleted by being bleached out from the bright disabling light.
The sun is also the primary source of harmful blue light which can adversely affect the eye e.g. cataracts and macular degeneration and hence on driver safety.
Drivers have a duty of care to ensure their health, including eye health, is as good as possible. Reasonable care must be taken so actions would be unlikely to injure neighbours, passengers and pedestrians.
More than 480,000 people aged over 40 in Australia whose vision is currently too low for them to drive legally. Over three-quarters of these people could have their vision corrected quickly with a pair of glasses or contact lenses.
The examination findings for a driver’s licence determine Y/N that the standard for unconditional approval is met. Vehicle drivers and car manufacturers have become very focused on safety, and rightly so.
Most are concerned about their car’s abilities but don’t think about the major influential factor in crashes: human error, significantly if reaction time reduced due to poor focusing.
We prescribe the appropriate driving glasses, eyeglasses or contact lenses so driving is safer, more exact and more comfortable and can certify your vision as safe to drive. Some types of transitions lenses are not ideal for driving conditions.

Safe for night driving
XTRActive Polarized
XTRActive New generation
Transitions GEN 8

Not suitable for night driving
XTRActive style mirrors
Transitions Drivewear

Sunglasses are not suitable for night driving
Day driving – Polarized sunglasses are an option
XTRActive Polarized does not Polarize behind a car windscreen


XTRActive Polarized has a slight tint which is usually barely noticeable,as higher indexes and coatings per lower Abbe number can also show some have tint so a 1.67 will be slightly more than a 1.5 however not normally noticeable

Our advice can go beyond eye exams and eye charts. It is more thorough than just ensuring vision standards that need to be met in the respective driver licensing authorities’ relevant eyesight test to avoid trouble seeing e.g. pedestrian crossings, road signs, speed bumps, or cyclists. Acoustic Vehicle Alerting Systems (AVAS) ideally should be fitted to all hybrid and electric vehicles.
1 in 5 drivers can’t see the road clearly due to uncorrected low vision. The World Health Organisation has declared poor eyesight among the main risk factors for road crashes despite email marketing and traditional health awareness campaigns.
Surveys show that an alarming number of drivers on the road in developing countries have uncorrected vision. Traffic fatality rates are far higher in low-income countries; e.g. in Africa, for example, the rate is nearly triple that of Europe, according to the WHO.
Drivers with visual field defects have double the incidence of road crashes and traffic violations than drivers with a full visual field. Almost half of the people with visual field loss are unaware of their visual impairments.
When buying a car, 5-star safety is among the most important considerations – but drivers don’t consider themselves to be one of those essential safety features. We know that vision is the most important source of information for a driver and that uncorrected vision is a contributor to crash risk.
During the day or night, Glare is the most complained about visual discomfort by drivers and slows both detection and reaction time.
The advantage of wearing polarised lenses outweighs the difficulty of seeing some polarised LCD display panels depending on their polarisation angle. Unlike some earlier displays, cars with the latest heads up displays work well with Polarised lenses ( as have polarisation along the 45-degree line ) Heads up display types by reflection could change the polarisation, however.
Sometimes a contrasting tint or regular tint could benefit in these situations. Ensure you clean and see all your mirrors, windows, and windscreen for maximum field of vision. The correct prescription and tint avoid eyestrain, headaches and difficulty concentrating.
Air conditioning, such hours of concentration without blinking, and wearing contact lenses can all cause eyes to dry out. Carry lubricating eye drops to moisten tired, dry eyes.

  • Cataract surgery does  reduce the crash rate
  • Visual acuity is a poor visual predictor of driving performance and safety
  •  Alternative visual tests including motion sensitivity, contrast sensitivity and visual fields better predict driving abilities.
  •  No measure alone accounts for all the variation in driving ability.
  • Licencing ideally should be based on performance rather than age or disease status
  • Driving at night is dangerous with fatality rates at night are 3x higher than in the day
  • Night-time safety risk is highest for pedestrians which are  7x more vulnerable to a fatal collision at night than the day
  •  Poor visibility is the leading cause of vehicle collisions with pedestrians, cyclists, and other low-contrast obstacles
  • The normal visual field for an eye based on  60 degrees nasally, 100 degrees temporally, 75 degrees inferiorly and 60 degrees superiorly. The ‘horizontal extent’ includes nasal and temporal fields.
  • The risk of crash in drivers with restrictive  hemianopia or quadrantanopia is known to be higher if  there is any significant visual field loss (scotoma) with more than four contiguous spots within a 20 degree radius from fixation 
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All private and commercial have specific legal responsibilities concerning their health and driving.
The laws require drivers to report any permanent or long-term illness that is likely to affect their ability to drive safely to the Driver Licensing Authority.
A professional driver and a private driver are responsible for their health and the use of drugs and alcohol, affecting being ‘fit to drive’.

 

 

A range of medical conditions, as well as treatments, may therefore impair your ability to undertake your work safely and driving. Common examples include:

Blackouts, Sleep disorders, Vision problems, Diabetes, Epilepsy and seizures Psychiatric disorders, Heart disease.

Some eg migraine tints are not suitable for night driving.

 

Visual Acuity and Visual Fields Standards for Driving

Pupil size, contrast, optotype used, and other interaction effects can cause variations in visual acuity.

Visual condition Licence for car, motorcycle, truck license or boatLicence for bus or truck
Uncorrected Visual AcuityThe minimum requirement for holding a private drivers license is visual acuity of 6/12 or better (using both eyes). Aided or unaided vision is acceptableCorrected (with glasses or contact lenses) or uncorrected visual acuity must be better than 6/9 in the best eye and at least 6/18 in the worst eye.The minimum requirement for holding a private drivers license is visual acuity of 6/12 or better (using both eyes). Aided or unaided vision is acceptable.  
Note

  Must meet all visual criteria.

Two yearly reviews required.

May drive if visual acuity and visual field standards are met.

It may be subject to the annual review of vision and visual fields.

May be subject to annual review of vision and visual fields.

At a minimum, visual acuity must be met.

Standards for visual fields must be met. If considered suitable, a license may be considered, subject to an annual review of visual fields.

Loss of vision in one eye

Should not drive for three months after losing sight in one eye.

May then drive if the vision in the good eye meets visual acuity standards.

May drive if the visual acuity standards are met.
Poor night visionA conditional license may be issued for daylight driving.A conditional license may be issued for daylight driving.

Closed Angle Glaucoma

Applicants should have the condition surgically corrected. 

Open-Angle Glaucoma

Aviation Medicine requires a satisfactory ophthalmologist’s report.

Colour Vision

An applicant who fails to meet the colour perception standard (i.e. who fails both the Ishihara Plate Test and the Farnsworth Lantern but who meets all other criteria) is eligible for the issue of an operationally restricted student pilot, private pilot or commercial pilot license. The holder of such a licence is given a dispensation to operate at night in a suitably radio-equipped aircraft. This dispensation applies to Australian airspace only.

Class 1 and class 2 applicants who cannot pass either the Ishihara Plate Test or Farnsworth Lantern Test may be further assessed employing the Practical Signal Light Test.

A “recreational” Pilot’s licence, requires meeting the Austroads Fitness to Drive unconditional private driver standards.

Monocular Pilots

Cases where applicant has only one functioning eye or applicant has two eyes, but the visual acuity of one cannot be corrected to 6/9 or better. Provided the visual acuity requirements are  met in the functioning eye, with or without correction, a waiver is granted for Class 2 certification, limited to Australian airspace.

A person whose visual acuity in either eye is worse than 6/60 must provide a full ophthalmic report to CASA.

Intraocular lenses

IOL’s are allowed assuming other crieria met but not the multifocal type of IOL

Medical standard 1

Applies to  applicants for licences of the following kinds:

Commercial pilot licence, airline transport pilot, license flight navigator or flight engineer.

Visual requirements

  • Eyes function typically without being afflicted from any safety-relevant pathological condition (either acute or chronic), nor any sequelae of surgery or trauma
  • Normal fields of vision and normal binocular vision
  • Distance visual acuity of 6/9 or better in each eye separately and 6/6 or better binocular (with or without correcting lenses)
  • Can read (with or without correcting lenses) an N5 chart (or its equivalent) binocularly at a distance  (in the range of 30 to 50 centimetres), and can read an N14 chart binocularly (with or without correcting lenses) at a distance of 1 metre
  • Near point of accommodation no further away than 30 centimetres (with or without correcting lenses)
  • If using contact lenses to meet the visual standards :
  • Is  able to wear those lenses for twice the projected length of flight time or duty time for the person without deterioration in visual acuity or discomfort; and If  the lenses are of the hard or gas-permeable variety, demonstrates the ability, immediately after removing the lenses, to read at least 6/9 with spectacles binocularly.
  • Colour perception such that can readily distinguish the colours that need to be determined for the safe exercise of privileges or performance of duties under the relevant licence

Medical standard 2

Private pilot licences (aeroplane or helicopter)

Glider pilot license

Free balloon pilot license.

Visual requirements

  • Eyes  function normally
  • Not  suffering from any safety-relevant pathological condition (either acute or chronic), nor any sequelae of surgery or trauma
  • Normal fields of vision and binocular vision
  • Distance  visual acuity of 6/12 or better in each eye separately and 6/9 or better binocular (with or without correcting lenses)
  • Read (with or without correcting lenses) an N5 chart (or its equivalent) binocularly at a distance in the range of 30 to 50 centimetres, and can read an N14 chart binocularly (with or without correcting lenses) at a distance of 1 metre
  • Near point of accommodation no further away than 30 centimetres (with or without correcting lenses)
  • If  using contact lenses to meet the visual standards
  • Is  able to wear those lenses for twice the projected length of flight time or duty time for the person without deterioration in visual acuity or discomfort; and
  • (b) if the lenses are of the hard or gas-permeable variety, demonstrates the ability, immediately after removing the lenses, to read at least 6/9 with spectacles binocularly
  • Colour perception such that can readily distinguish the colours that need to be determined for the safe exercise of privileges or performance of duties under the relevant licence

Medical standard 3

Air traffic controller licences.

 A person may use contact lenses if the lenses are monofocal and not tinted, and are well tolerated.

 A person whose visual acuity in either eye is worse than 6/60 must provide a full ophthalmic report to CASA.

A person who has undergone surgery affecting the refractive status of either eye is taken not to meet the criterion until they are free of safety-relevant sequelae of the surgery.

A person who requires both near correction and distant correction must demonstrate that one pair of spectacles is sufficient to meet both requirements for correction.

Where  a person applies for a class 3 medical certificate, the person must demonstrate that they meet the criterion  in daylight, or artificial light of similar luminosity, readily identifying a series of pseudo-isochromatic plates of the Ishihara 24-plate type, making no more than 2 errors.

Visual requirements

  • No sequelae of surgery or trauma and routine function
  • Normal binocular vision with regular fields of vision
  • Distance visual acuity of 6/9 or better in each eye separately and 6/6 or better binocular (with or without correcting lenses)
  • Read (with or without correcting lenses) an N5 chart (or its equivalent) binocularly at a distance that he or she selects (in the range of 30 to 50 centimetres), and can read an N14 chart binocularly (with or without correcting lenses) at a distance of 1 metre
  • Near point of accommodation no further away than 30 centimetres (with or without correcting lenses)
  • If using contact lenses to meet the visual standards
  • Is able to wear those lenses for twice the projected length of duty time for the person without deterioration in visual acuity or discomfort; and
  • If the lenses are of the hard or gas-permeable variety, demonstrates the ability, immediately after removing the lenses, to read at least 6/9 with spectacles binocularly
  • Colour perception
  • Can readily distinguish the colours that need to be determined for the safe exercise of privileges or performance of duties.

National standards are available for a range of bodies, e.g.:
Australasian Fire Authorities Council (AFCA)
Australian Defence Force with vision standards for ADF varying due to the wide range of occupations within the Army, Navy and Air Force.
Australian Federal Police
Disability Pension (based on legal blindness)
Electrical There are currently no vision standards for electricians in Australia; however, individual employers may have their requirements and often require normal colour vision.
Rail Safety Workers (e.g. train and tram drivers)
National Standard for Health Assessment of Rail Safety Workers – The positional cues of traffic lights for tram drivers (similar to vehicle drivers) means that colour vision is not a medical requirement for tram drivers.
State-specific standards may apply to police

pilots vision

Pilots undergo several medical tests in addition to the standard medical examination.  All age required tests are due at the first renewal after the appropriate birthday.

Class 1 and 3 medical certificates require specific tests and an eye examination by CASA Designated Aviation Ophthalmologist or Credentialed Optometrist. Class 2 There are no special requirements unless clinically indicated.

Pilots are known to be more susceptible to cataracts due to higher levels of UV radiation at altitude. For pilots, just like drivers of motor vehicles, the right sunglasses and prescription are essential.

Visual fields and driving

Private vehicles, Cars, Motorcycles, Light Trucks

In a standard binocular Estermann plot, 120 points are shown in the visual field. License visual field minimum requirement is that no points must be missed along the horizontal meridian over an area subtending 120 degrees. The binocular field must have a horizontal extent of at least 110 degrees within 10 degrees above or below the horizontal midline and no significant field loss/ scotoma within a central radius of 20 degrees of foveal fixation.

A conditional licence may be considered taking into account any information provided by an optometrist or ophthalmologist

 

Buses and Trucks

A person is not fit to hold an unconditional licence if they have any visual field defect.
A conditional licence may be granted subject to evidence from an optometrist or ophthalmologist subject to the following:

The binocular visual field has an extent of at least 140 degrees within 10 degrees above and below the horizontal midline.
No significant field loss/scotoma, hemianopia, quadrantanopia likely to impede driving.
Field loss is static and unlikely to progress rapidly.

In cases of reduced fields

“Scattered single missed points, or a single cluster of up to three adjoining points is acceptable central field loss for a person to hold an
unconditional licence.

A significant or unacceptable central field loss is defined as any of the following:

• a cluster of four or more adjoining points that are either entirely or partly within the central 20-degree area
• loss consisting of both a single group of three adjoining missed points up to and including 20 degrees from fixation, and any additional
separate missed point(s) within the central 20-degree area
• any central loss that is an extension of a hemianopia or quadrantanopia of size greater than three missed points.”

Typical uses of these fields and no of points threshold tested include

Binocular Driving 80° 119
Binocular Single Vision Superior 30°, Inferior 40° 21
Central 22° 45 – 96
Central 22° 50
Central 30° 100
Driving 80°/50° 107
Flicker 15°/22° 74
Full Field Full 50° 164
Glaucoma Central 22°,
Nasal step 50° 104
Macula Central 10° 48

Neurological Full 50° 164

Peripheral 30° to 50° 72
Quickscan (deprecated) 22°/30° 40
Flash Scan 22°/30° 40
Spatially Adaptive 50° 39 – 168
CV% 100 Point 60° 100

Any person who has, or is suspected of having, a visual field defect should have a formal perimetry-based assessment. Visual fields are defined as a measure of the extent of peripheral (side) vision. Visual fields may be reduced as a result of many neurological or ocular diseases or injuries. Monocular people may meet the standard for private vehicle driving but would not meet the unconditional commercial standard.

A longstanding field defect may lead to visual compensation. For example, such defects, for instance, hemianopia from childhood, need to be assessed by an ophthalmologist/optometrist for a conditional license to be considered. Good rotation of the neck is also necessary to ensure adequate overall fields of vision, particularly for monocular drivers

For Private Motor Vehicles, Heavy Vehicle, bus, commercial license::

Confrontation field testing is not definitive so assessment by an optometrist or ophthalmologist for automated perimetry. If the automated perimetry suggests that the requirements for an unconditional license are not met, then the Estermann binocular field test should be performed. While opinions on fitness to drive can be based on visual testing fields for each eye separately, the Estermann binocular field is the preferred method of assessment. In the case of a private vehicle driver, if a person’s visual fields are just below that required by the standard but the person is otherwise alert, has normal reaction times and good physical coordination, an optometrist/ophthalmologist may support the granting of a conditional license by the driver licensing authority. There is no flexibility in this regard for commercial vehicle drivers.

Esterman Visual Field Test

Any person who has, or is suspected of having, a visual field defect should be referred for assessment by an optometrist or ophthalmologist. Assessment will involve automated perimetry using an automated static perimeter (Kinetic Goldman Visual Field, Humphrey Field Analyser, Medmont M700, Octopus, etc.)

If the automated perimetry suggests that the requirements for an unconditional license are not met, then the Estermann binocular field test should be performed. While opinions on fitness to drive can be based on testing visual fields for each eye separately the Estermann binocular field is the preferred method of assessment.
In the case of a private vehicle driver, if a person’s visual fields are just below that required by the standard but the person is otherwise alert, has normal reaction times and good physical coordination, a conditional license can result from the driver licensing authority. There is no flexibility in this regard for commercial vehicle drivers.

Much like the Snellen scale for central acuity, the Esterman scale is especially useful for evaluating visual capability or disability.
The Esterman test scores are based on a relative value scale, which is divided into unequal units of 100 for monocular tests and 120 for binocular tests. Each unit is equated to one test point and is given a value of 1% in the monocular field and 0.83% in the binocular field. The inequality in the size and distribution of the units, with greater unit density in more important areas, makes the scale functional. A functional score is expressed as a percentage.
Monocular tests incorporate 100 points and extend 75 degrees temporally and 60 degrees nasally. Binocular tests incorporate 120 points and extend 150 degrees bitemporally. Each stimulus duration is 400 milliseconds with a single intensity Goldmann stimulus of III 4 E (10 dB). These settings have been standardized by international agreement.

Roving and regular esterman setup refers to the instruction during testing to the patient to not fixate or fixate on the central target. They can “look around” in a natural way in the former.
No threshold testing in Esterman tests,each ring represents 10 degrees.
The roving binocular Esterman is the same test – same patient setup however the patient is instructed they can move their eyes during the test (vs. asking them to keep their eye looking straight ahead and monitoring their fixation manually from the side).

The difference in results can be quite marked as allowing the patient to rove will often mask visual field defects.

The Medmont driving test is considered to be equal by the RMS. 

Subjects with any significant field defect or a progressive eye condition require a binocular Esterman visual field assessment or Medmont equivalent with reliable fixation monitoring of false-positive no more than 20 per cent.

Optometry Australia has been advised that although the Assessing Fitness to Drive document states that the Humphrey Esterman test should be used, VicRoads and the NSW Roads and Maritime Authority (and likely other driver authorities) recognise the Medmont Binocular Driving Test as equivalent and meets worldwide standards to check a driver’s visual field, 160° of a patient’s visual field.

A normal visual field is an island of vision measuring 90 degrees temporally to central Fixation, 50 degrees superiorly and nasally, and 60 degrees inferiorly.
Field tests can show either relative or absolute defects if not normal.
Visual acuity increases from movement discrimination in the extreme peripheral vision to better than 6/6 or 20/20 in the centre of vision.

Binocular vision which is required for stereopsis ( depth perception), covers 115 degrees (horizontally) of the human visual field the remaining peripheral 40 degrees on each side have no binocular vision (as only one eye having monocular vision ie vision in one eye can see those parts of the visual field.)
A person is not fit to hold an unconditional licence if the binocular field does not have a horizontal extent of at least 110 degrees within 10 degrees above or below the horizontal midline or if there is significant field loss/ scotoma within a central radius of 20 degrees of foveal Fixation.

Esterman efficiency score is a score based on the stimuli seen
In Australia drivers are not specifically passed or failed on the their ESS; there are 120 points tested using suprathreshold stimuli; each point is assigned a value of 1.
Then the number of points seen is multiplied by 5/6 to obtain the ESS; Eg score of 100 means they saw all 120 points
This score however is biased inferiorly given that there greater number of points measured inferiorly on the esterman testing regime (The genesis of the Esterman protocol was for testing walking mobility). Driving typically involves greater superior and central visual field usage which the esterman isn’t programmed comprehensively to assess. The Esterman is the current ‘gold standard’ but not ideal.
The score in itself does not pass or fail the driver according the guidelines.

• A conditional licence may be granted subject to evidence from an optometrist or ophthalmologist that the following conditions are met:
1. Binocular visual field has an extent of at least 140 degrees within 10 degrees above and below the horizontal midline.
2. No significant field loss/scotoma, hemianopia, quadrantanopia likely to impede driving.
3. Field loss is static and unlikely to progress rapidly.

Monocular drivers ( sight in one eye or drivers with only one eye ) can be considered for conditional licences.

Peripheral vision
Most studies on the elderly find that peripheral vision is essential in driving and postulate that peripheral visual health is a much better predictor of driving ability than visual acuity (Huestegge and Bockler, 2016; Peli et al., 2016).
Studies have also implicated peripheral visual deficits as a larger cause of pedestrian accidents in dementia patients than cognitive impairment alone (Owsley and McGwin, 2010)

Colour vision

There are no specific requirements relating to colour vision. Patients with a colour deficiency likely to affect their capacity to respond appropriately to signal lights should be informed of this.

Progressive conditions

Monitor regularly and advise in advance of potential future impact on driving ability. Progressive conditions include, e.g. cataract, glaucoma, optic neuropathy, retinitis pigmentosa.

Medical Health professionals also need to certify for fitness to drive as well as an optometrist eye test

Esterman binocular fields

For Private Motor Vehicles, Heavy Vehicle, bus , commercial licence requirement:
At least 120 degrees of Binocular Visual Field in the better eye with a IV4e target across the horizontal midline or equivalent in a Estermann Field test. Licence visual field requirements specify that no points must be missed along the horizontal meridian over an area subtending 120 degrees, and no significant defect within the central  20 degrees

driver fatigue

Driving safely 
Virtually any outdoor activity is more enjoyable with polarized sun lenses.
Transitions drivewear high contrast yellow green filter with  37% transmission and a very high contrast efficient polarizer, DriveWear seems to make the world look brighter, but any reduction in light transmission is highly questionable at night.

 

NIGHT DRIVING GLASSES

night driving vision

NIGHT DRIVING GLASSES

No tint should ever be used at night as the eye relies on maximum light for night visual discrimination. 
 
Rayleigh scattering occurs when the scattering particles are around the same size as the wavelength of light so more blue is scattered enabling the blue sky we perceive. However so-called Mie scattering from the larger fog particles is not specific to any wavelengths of the seven rainbow colours of the visible light spectrum as evidenced by clouds appearing white.

Anti-reflection coated prescription lenses can significantly improve night driving vision and drivers response time as the contrast of bright lights from oncoming cars can highlight noticeable halo or starburst reflections diminishing visual acuity.

On the other hand, there is much justification for putting anti-reflection coatings on clear lenses to benefit the driver at night.  These coatings are very effective at blocking out the distracting reflections which headlights and overhead lights can produce on the wearer’s lenses.  These reflections are minimized and certainly can help the night driver’s vision and response time. eg
Sodium street lights in fog enable short wavelengths to increase the penetration of light in the fog without reducing the amount of light coming into the eyes at night. It slows reaction time and reduces peripheral vision.
The best option for nighttime driving is a pair of spectacles with clear lenses and an AR coating. The AR coating is beneficial in two ways. First, it minimizes internal reflections within the lenses, reducing halo problems, and second, it increases the transmittance of light through the lens to the eye. However, it is important to note, if a patient does not normally wear spectacles, AR coated lenses, or any other type of night driving glasses will not improve night vision, as AR coatings only minimize aberrations that are inherent in ophthalmic lenses and night driving glasses will simply serve to introduce those abberations to the wearer’s vision.

Transitions lenses can be multicoated but not tinted as it may damage the photosensitive coating
Transitions lenses except for drivewear are only activated by UV radiation. The sun is the most significant source, but there are other sources, including computers, cameras, arc welders etc., so in summary, any source that emits radiation will affect Transitions. Headlights, unless they emit UV, will not so, effect.

Ultraviolet light has a shorter wavelength than ordinary light and is invisible to the human eye. However, when ultraviolet light is reflected in certain materials, it is returned on longer wavelengths and becomes visible. This phenomenon, known as fluorescence, makes objects more visible and therefore offers a considerable potential for improving safety which is why research in UVA headlamps to enhance nighttime visibility is ongoing. 

Nighttime driving is one of the motorist’s most difficult tasks. The risks of having a nighttime accident on the road are 2 to 3 times greater than during the daytime due to visibility issues from older Halogen/Filament Bulbs or newer HID/Xenon lamps and LEDs.

Tips for optimal night-time driving vision:
– Make sure eyes are examined regularly

– Always wear an up-to-date prescription
– Lenses worn should be clear with an AR coating
– Ensure lenses are clean
– Ensure windshield is clean
– Ensure headlights are clean and properly aligned.

Driverless cars are not concept cars any more as significant tech companies, from Apple to Google to Uber, have self-driving cars employing Lidar sensors.

LIDAR —Light Detection and Ranging employed as a remote sensing data protection services detect the Earth’s surface and instantly see any potential hazards, and contains a deep learning system sophisticated enough to respond immediately to obstacles and weather hazards. 

If driverless cars of the future detected unusual traffic activity,there is a need to ensure real humans can access protection services to override where needed.   Such online data protection services detect unusual traffic originating from without but likely to encroach into the cars safety margin sphere.

In the current era of drivers being in control, safety issues arise, such as e.g. if a cyclist was present during a drivers saccade, they could be missed as the  door pillars on a car, therefore, create an even more expansive blindspot (called windscreen zoning)
Each eye has its blind spot area that the brain essentially fills in.
To overcome the risk of missing something that falls in a drivers blind spot, judicious use of mirrors is required and techniques such as leaning forward slightly as you look right and left so that you are looking around the door pillars. Be aware that the pillar nearest to you blocks more of your vision.

Drive with your lights on. Bright vehicles or clothing is always easier to spot than dark colours that contrast with a scene.
It is challenging to spot bicycles, motorbikes and pedestrians during low sun conditions as the contrast is reduced and a clean windscreen helps.

There is a noticeable visual phenomenon often associated with polarized lenses called cross-hatching. It can be seen in the side windows of automobiles as a crosshatch pattern in the glass. Auto side windows are tempered for safety reasons (windshields are laminated). Tempering induces stress that shows up in transparent materials as a pattern when viewed through polarized lenses.

Many modern instruments are often illuminated with LCD (liquid crystal diodes). When some of these are viewed through polarised sunwear, they can appear to be blacked out.  With the growing popularity of polarized sun lenses, automobile manufacturers are careful to align the orientation of their instruments properly

 

CYCLISTS AND ROAD SAFETY

High contrast clothing, flashing LED’s (front and rear) are especially effective for cyclists as they create contrast and the on-off flashing attracts the peripheral vision in the same manner that movement does.
Flashing lights are more eye-catching during a drivers saccade but flashing bike lights can diminish a driver’s ability to make accurate judgments of relative speed and distance.
Steady lights are easier to see when moving  – when it is vital that a driver can judge a bicycle’s relative speed and distance.
Cyclists can benefit from suitable sun glasses,contact lenses and corrective eye wear as required.

DRIVING ASSESSMENT APPEALS

Road driving exam

DRIVING ASSESSMENT AND RETRAINING
In NSW, the RMS is responsible for ensuring all drivers are medically fit to drive. The law requires all licensed drivers to report directly to the RMS any long term or permanent medical condition that is likely to affect their ability to drive.
Driver trained and certified Occupational Therapists can arbitrate in equivocal cases eg those with a superior quadrant loss to the left will be more affected driving in Australia than those with upper right quadrant loss, due to placement of the interior rear-vision mirrors being in that upper left quadrant.

Transport for NSW has introduced improved and simplified online Fitness to Drive forms for GPs, specialists, optometrists and allied health professionals.
Doctors who don’t have a practice software system can still submit forms electronically via the Healthlink portal with a standard web browser. Proda message inbox and Transport NSW has more information on accessing the online form.
The online forms, now with one for each of the relevant specialties, will generate a real-time response shared with patients on the spot.
Links to the Austroads Assessing Fitness to Drive Guidelines – the Australian medical driving standards for commercial and private vehicle drivers – are included in the forms. When health professionals complete the form online, patients will no longer need to take their paper form to a Service NSW Centre.
Eg Mr Jones will be turning 75 years of age in the next eight weeks. He does not have any medical conditions declared on his driver licence.
Transport for NSW sends him a request to have a NSW Fitness to Drive assessment, as it is mandatory for all NSW driver licence holders 75 years and over to have an annual medical review.
He attends his local GP, who opens up the NSW Fitness to Drive form through the Electronic Medical Records system on his computer and types in Mr Jones’ licence number. This form shows that Mr Jones does not have any pre-existing medical conditions.
The doctor indicates that Mr Jones has a vision and eye disorder, atrial fibrillation and a mild case of arthritis. The doctor makes a recommendation that Mr Smith is fit to continue to hold his driver licence.
The GP submits the medical assessment, which is transmitted directly to Transport for NSW. The GP receives a real-time response which indicates Transport for NSW has received the medical evaluation and that Mr Jones is required to have his vision reviewed by an Optometrist or Ophthalmologist to continue to hold a driver licence. The GP can print out a copy of the medical review and the real-time response for Mr Jones to keep.
Mr Jones leaves the GP knowing that he needs to see his Optometrist.
Transport for NSW sends Mr Jones a letter advising he needs to see his Optometrist or Ophthalmologist to check if his vision meets the required standard to hold a driver licence.
Mr Jones makes the appointment with his local Optometrist, who then logs into the online eyesight report form. The Optometrist completes and submits the form and advises Mr Jones that his vision meets the standard to continue to hold a driver licence.
The Optometrist receives real-time advice which confirms TfNSW has received the eyesight report form. The Optometrist can print the result out for Mr Jones to keep with his records. Mr Jones has now completed the steps to maintain his driver licence.
RMS may, pending a medical and vision report, suggest you undertake an OT (Occupational Therapist )driving assessment to determine if the medical condition impacts your ability to drive safely and legally. Sometimes we can successfully appeal these decisions on your behalf.
On-Road Assessment: The assessment occurs in a dual controlled car with a qualified driving instructor and the driver trained, OT. This may be in an automatic or manual car, depending upon what you are used to driving or what your medical condition requires.
Failure to report and choose to drive may put lives at risk and result in serious legal and financial consequences, including loss of insurance cover.
There are some recommendations and outcomes that can result from the assessment. These include:
Fit to drive with no other intervention;
Fit to drive with specific conditions such as a limited distance from home, going only in daylight hours
Fit driving an automatic vehicle only;
Driving lessons to learn compensatory techniques, to regain confidence or to upgrade driving skills;
Driving lessons to learn competency in driving with specialised vehicle modifications.
Driving with steering aid, hand controls or a left foot accelerator.
Suspension of the licence whilst waiting for further recovery
Unfit to drive, with licence cancellation.
At times a person may be issued with a learner’s licence to complete the driving assessment or driving tuition.
To drive legally with specialised vehicle modifications, a person must have the changes endorsed on their licence. They will be required to undertake an RMS Disability Driving Test to prove competency and safety driving with the modifications;
Occupational Therapy Australia NSW has a list of driver trained OTs throughout NSW, both hospital-based and those OTs in private practice.
Contact details are:
Phone: (02) 9648 3225
Email: [email protected]
Website: www.otaus.com.au
RMS updated driver reporting portal
Problems accessing or submitting Fitness to Drive form online can be sorted via HealthLink on 1800 125 036.

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