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
Visual Field and Visual Acuity standards for driving vary by state. Below are listed the standards for Iowa and surrounding states.
Driving with a Visual Impairment
Illinois
Visual Acuity |
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≥20/40 in one or both eyes |
No restrictions |
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20/41-20/70 in one or both eyes |
No driving when headlights are required |
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20/71 - 20/100 in one or both eyes |
Bioptic telescope required unless living in a town with a population of 3000 or less
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< 20/100 in one or both eyes |
License denied |
Visual Field: (uninterrupted is not specified) |
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> 140 degrees binocular or monocular |
No restrictions |
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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 |
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< 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 |
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> 20/40 in one or both eyes |
No restrictions |
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20/41-20/70 in one or both eyes |
No driving when headlights are required
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20/71 – 20/199 in one or both eyes |
Discretionary issuance
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< 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) |
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≥ 140 degrees binocular |
No restrictions |
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< 140 degrees but >110 degrees binocular or≥100 degrees monocular |
Will be required to have a left and right outside mirror |
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<110 degrees binocular or <100 degrees monocular, but ≥75 degrees monocular or binocular |
Discretionary issuance
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<75 degrees binocular or monocular |
Discretionary issuance
|
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<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
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Visual Acuity |
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> 20/40 in one or both eyes |
No restrictions |
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20/41-20/160 in one or both eyes |
Discretionary issuance |
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< 20/160 in one or both eyes |
License denied |
Bioptic Telescopes: Not allowed to achieve the visual acuity standards noted above
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Visual Field: (uninterrupted is not specified) |
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>55 degrees in each eye or 85 degrees monocular |
No restrictions |
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70-109 degrees binocular or monocular |
Discretionary issuance |
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<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
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Visual Acuity |
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> 20/40 in one or both eyes |
No restrictions |
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20/41-20/70 in one or both eyes |
Speed restrictions
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20/71 - 20/99 in one or both eyes |
Discretionary issuance
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< 20/100 |
License denied |
Bioptic Telescopes: Not currently allowed to achieve the visual acuity standards noted above
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Visual Field: (uninterrupted is not specified) |
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≥105 degrees binocular or monocular |
No restrictions |
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< 105 degrees binocular or monocular |
Discretionary issuance
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<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
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Visual Acuity |
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> 20/40 in one or both eyes |
No restrictions |
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20/41-20/60 in one or both eyes |
No driving when headlights are required |
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20/60-20/70 |
If blind in fellow eye, license will be denied |
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20/70 in one or both eyes |
No driving when headlights are required and speed limitations |
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< 20/71 in one or both eyes |
License denied |
Bioptic Telescopes: Are allowed to achieve the visual acuity standards noted above
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Visual Field: (uninterrupted is specified) |
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> 140 degrees binocular or monocular |
No restrictions |
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139-120 degrees binocular or monocular |
Vehicle must have left and right outside mirrors |
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100-119 degrees binocular or monocular |
No driving when headlights are required |
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< 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
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Visual Acuity |
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> 20/40 in one or both eyes |
No restrictions if fellow eye is at least 20/50 |
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If fellow eye less than 20/60, left and right outside mirrors required |
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20/41-20/60 in one or both eyes |
Discretionary issuance
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< 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
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Visual Acuity |
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> 20/40 in one or both eyes |
No restrictions |
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20/41-20/100 in one or both eyes |
Discretionary issuance
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< 20/100 in one or both eyes |
License denied |
Bioptic Telescopes: Not allowed to achieve the visual acuity standards noted above
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Visual Field: (uninterrupted is not specified) |
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> 140 degrees binocular |
No restrictions |
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139-40 degrees binocular or monocular |
Discretionary issuance
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< 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.