Driving with a Vision Impairment

Driving with a Visual Impairment

Mark E. Wilkinson, O.D.

Director, Vision Rehabilitation Service

UIHC Department of Ophthalmology and Visual Sciences

Updated Aug. 1, 2012

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

Visual Field and Visual Acuity standards for driving vary by state. Below are listed the standards for Iowa and surrounding states.

Illinois

Iowa

Missouri

Minnesota

Nebraska

South Dakota

Wisconsin

PDF iconDriving with a Visual Impairment


Illinois

Visual Acuity

 

≥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)

 

> 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 degrees binocular or monocular

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:

https://www.dmv.org/il-illinois/disabled-drivers.php#Vision-Impairments


Iowa

Visual Acuity

 

> 20/40 in one or both eyes

No restrictions

20/41-20/70 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 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
  • 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 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)

 

≥ 140 degrees binocular

No restrictions

< 140 degrees but >110 degrees binocular or≥100 degrees monocular

Will be required to have a left and right outside mirror

<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: https://directory.iowa.gov/Organization/Details/department-of-transportation

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.

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 allow 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.

Missouri

Visual Acuity

 

> 20/40 in one or both eyes

No restrictions

20/41-20/160 in one or both eyes

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)

 

>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: https://dor.mo.gov/motorv/

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


Minnesota

Visual Acuity

 

> 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 currently allowed to achieve the visual acuity standards noted above

Visual Field: (uninterrupted is not specified)

 

≥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

 

> 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

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)

 

> 140 degrees binocular or monocular

No restrictions

139-120 degrees binocular or monocular

Vehicle must have left and right outside mirrors

100-119 degrees binocular or monocular

No driving when headlights are required

Radius from home and speed limitations

< 100 degrees binocular or monocular

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: https://dmv.nebraska.gov/dl/driver-licensing-services

To print a copy of the driving form: https://dmv.nebraska.gov/forms


South Dakota

Visual Acuity

 

> 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

 

> 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 not specified)

 

> 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: https://wisconsindot.gov/Pages/dmv/license-drvs/rnew-and-chge/vision-standards.aspx


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 who are visually impaired and 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".
  • 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.