Independent Travel Issues
Driving with a Bioptic System: One User's Experiences
"I'm sorry, but you'll never be able to drive a car" is a statement that my brother and I heard our father say from the time we were very young. We were both born with congenital cataracts, had operations at about the age of six months, and grew up wearing "Coke bottle" glasses. Those were fine for reading, but not so good for distance viewing, and obviously not good for driving. Though it was disappointing, we resigned ourselves to not driving and got on with our lives.
I went to see my first low-vision specialist, Dr. J. D. Newman, during my senior year of high school for some assistance with reading music for band. He prescribed a pair of glasses with telescopes mounted near the bottom of the lenses that focused at approximately 14 inches. These bioptic glasses allowed me to read my music through the telescopes and see the band director through the top part of the lenses. They worked very well for that purpose.
When I visited Dr. Newman again a couple of years later, he told me that if he moved the telescope up to the top of the lens and focused it for infinity, I might be able to drive" Well, after I picked myself up off the floor I said, "Let's do it!"
Dr. Newman also informed my dad and me that Florida, where we lived, had started allowing some people with low vision to drive under certain strict conditions. Dr. Newman measured my visual acuity and visual fields and determined that I met the minimum requirements. He adjusted the bioptic glasses for driving and then told my dad to take me home, get my learner's permit, teach me how to drive, and then come back to let him check me out. My dad figured that the safest place to teach me to drive at first was an abandoned airfield. This was great for avoiding accidents--there was nothing to run into in the vast openness of the airfield--but it didn't do much for teaching me how to drive in traffic.
When I went back to see Dr. Newman he made me drive on the street for the first time. Needless to say I was scared to death, but I must have done okay because he told me I was ready to start learning how to drive on the streets. He said that after I got some more experience I would be ready to take the driving test. After a good bit of additional experience with my dad I took the test and passed it on the first try. Woo-hoo! I could now drive.
This was in the mid-1970s, when I was in my junior year at Florida State University. My dad helped me get a used car and I regularly drove in the small town of Tallahassee and to and from my parent's home in Miami several times.
I ended up going back to FSU for my master's degree, and it was during my first year in graduate school when I received a letter from the Florida Highway Patrol informing me, and all the other low-vision drivers, that our licenses had been suspended simply because the medical review board had decided to discontinue the low-vision driving program. The low-vision drivers in Florida tried to fight the change, but we were not successful. Today, almost 40 states have laws allowing bioptic driving under specific conditions. Laws vary from state to state, but often include restrictions such as: driving during daylight hours only and not driving in inclement weather.
After completing my master's degree I moved to Atlanta, Georgia, and began my career as a teacher of the visually impaired. At that time, Georgia did not allow low-vision drivers. During the next 15 years I used public transportation, my bicycle, my two feet, friends, and family to travel around the city. In 1992, Georgia passed a law allowing drivers with low vision the privilege of driving if they met certain requirements. I had already been working with an optometrist specializing in low vision so we began the process of getting me bioptic glasses and applying for a driver's license.
After spending many hours in the doctor's office and quite a bit of money, I was ready to begin the process. The first requirement was that I had to have training on the use of the bioptic. This sounded reasonable, but neither the doctor, nor his assistant (who would be doing the training) could tell me how many hours of training I would need. At first this was very irritating. The training was expensive and I had no idea how long it would take or how much it would cost in total. I later realized that there was no way the doctor could accurately predict how much time it would take for me to become competent at certain tasks using the bioptic system. My frustration with the situation stemmed from the fact that I had used a bioptic before, while neither the doctor nor the assistant had ever used a bioptic system themselves. In my own egotistical way I felt like I knew more about bioptics from a user standpoint than they did so I didn't want to pay approximately $90 per hour for training that I thought might be useless. I finally came to grips with the fact that I had to have the training if I wished to receive my license. Since I was experienced at using the bioptic I was able to complete the training in less than two hours. The tasks required in the training were realistic tasks that one would need to be able to do in order to drive safely, and I'm glad that this is a requirement for potential bioptic drivers.
Next I had to take a driver's education class consisting of 30 hours of classroom work and 6 hours of road work. I had not driven for over 15 years so I welcomed the opportunity to refresh my skills and learn more. To my surprise and amusement, the required class is the same class that teenagers and new drivers take to receive a reduction in their insurance premiums. I learned many important things from the driving instructor in my class and at he end of it he said he thought I was ready to take the test and begin driving. In fact, I did have the confidence and ability to drive safely at that time. I passed the test and began driving in a major metropolitan area, Atlanta. My license is restricted to daytime only and I am required to have outside mirrors on the left and right side of my car. I agree with both of these requirements.
The Driving Experience
One of the first things that a bioptic driver must learn is when to look through the telescope and when to look through the main (carrier) lens. Spending too much time looking through the telescope can be very dangerous because it limits the field of vision. However, the increased acuity through the telescope makes it very tempting to use it for extended viewing. The new driver must quickly learn not to succumb to this temptation because the narrow field of the telescope prevents the user from staying attuned to all the things happening in the periphery that are essential for safe driving.
It is estimated that most bioptic drivers spend 80 to 90 percent of the time viewing through the carrier lens and only use the telescope for short spot reading of signs, viewing actions on the road ahead, and locating and viewing traffic control signals. I'm not sure that this is true for me. I think I spend more time looking through the telescope. What I have learned to do is to move in and out of the telescope quickly and accurately. I think it's somewhat similar to the way other drivers quickly switch their gaze between the mirrors and the road ahead. I do this too, but I also take quick looks through the telescope to see what's happening further down the road. This allows me to have a little more reaction time to unexpected events happening two or three cars ahead, such as a car swerving or turning, or the appearance of a pedestrian.
If someone were to take a video of me driving you would probably notice that my head is pretty much in constant motion as I visually attend to the essential visual stimuli of the environment. The competent bioptic driver will learn to quickly switch between viewing through the carrier lens, viewing through the telescope, and returning to the carrier. Depending on the amount of traffic, this strategy works well for most drivers when driving on surface streets or highways. The addition of a GPS unit with spoken turn-by-turn directions makes this task easier and safer.
Tips for the Low-Vision Driver
The task of reading street signs and address numbers can be very difficult and requires the bioptic driver to quickly switch between the two viewing components of the system. There are a couple of strategies that can assist the low-vision driver when attempting to locate a particular street or address. One of my favorites is to ask for landmarks and navigation cues when acquiring directions to a location. For instance, you might receive the following directions when trying to locate a small business at 3029 Johnson Street.
- Exit the Interstate at 3rd Street and turn Left.
- Drive 1.2 miles on 3rd Street and turn Right on Harris.
- Drive about ½ mile on Harris and turn Left on Johnson.
- Proceed 1 mile on Johnson to 3029.
In this scenario, I would ask for the following additional information.
- What is the exit number for 3rd Street?
- How many traffic lights are there between the Interstate and Harris Street? Does Harris St. have a traffic light?
- What are some businesses on the corner of 3rd and Harris? Which corner? Do you know any landmarks I can look for in the block just before Harris Street?
- Repeat 2 & 3 for locating Johnson Street.
- Repeat 2 & 3 for locating 3029. Is 3029 on the left or right?
- What is the type, color, size, and location of the business's sign?
- If I go past 3029 what landmark will I see that will let me know I've missed it?
When traveling to a new location it's always a good idea to allow plenty of extra time in case you miss your destination and need to backtrack. Recently I had to locate a business on a road with many buildings side by side. I had asked for a landmark before and after the desired address. Armed with this information I thought I would have no problem finding the place because I was familiar with the area. After passing the landmarks twice and not seeing the desired address I decided to park my car nearby and walk. Even on foot, I had trouble locating the address. I finally found it down a driveway between two buildings. I had forgotten to ask about the business's sign. It was just a small 16-inch by 20-inch sign with the business name and address on the side of the building. There's no way I would have been able to read this from the road. Bottom line, being a safe driver with low vision requires good information and planning. My GPS didn't even help in this situation.
A large part of driving is mental. Thinking about the environment you're driving through and asking yourself, "What things might I encounter?" can be very critical. Having an idea of what types of activities, objects, vehicles, and people you might encounter can help a driver be prepared for unexpected circumstances. In order to deal with the unexpected, a driver with low vision will find it useful to be a cautious driver. By this I do not mean a "slow poke" driver, but one who follows good, safe driving practices. Rapid starts and abrupt stops can lead to crashes, in addition to poor gas mileage. (Are you non-bioptic drivers listening?) Not slowing down to an appropriate speed when turning corners can find you colliding with another vehicle or pedestrian. Exceeding the speed limit and tailgating are two extremely dangerous behaviors for a driver with low vision. Because of your reduced vision it's always best to give yourself as much reaction time as possible for an unexpected traffic event.
Drive Responsibly and Safely
Driving a motor vehicle is a privilege that is accompanied by a great deal of responsibility. I, for one, feel a great deal of responsibility for the public safety and mine. I also feel a responsibility to present the best possible image of drivers with low vision to the general public. I don't want to do anything that might make citizens petition their representatives to make driving laws more restrictive. I have had a fairly good driving record (not perfect) compared to the average driver, because I take the privilege and the responsibilities of driving very seriously, and I wish to continue driving for many more years.
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