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 to ensure your eye health.
To have a good chance of seeing an object whilst driving  we need to move our eyes, and probably head, to bring the 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.
We prescribe the appropriate driving glasses,eyeglasses or contact lenses so driving is safer, clearer and more comfortable and can certify your vision for fitness to drive purposes. Some types of transitions lenses are not ideal for driving conditions. Our advice can go beyond eye exams and eye charts.

Without Safe Driving Vision...

eye test before you crash

…a Safe Car Is Nothing
Research shows us  60% of road accidents can be attributed to impaired vision. Distance vision has not only to be clear but comfortable as well as well with effective intermediate and peripheral vision required for driving in all conditions and to reduce the risks inherent in driving a car.

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 especially if reaction time reduced due to poor focusing.
Vision standards need to be met in the relevant eyesight test set by the respective driver licensing authorities to avoid  trouble seeing  eg 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 poor 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 a worrisome number of drivers on the road in developing countries have uncorrected vision. Traffic fatality rates are far higher in low-income countries; in Africa, for example, the rate is nearly triple that of Europe, according to the W.H.O.​
Drivers with visual field defects have double the incidence of road crashes and traffic violations compared to drivers with a full visual field. Almost  half of 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 important 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.

Glare, during the day or night, is the most complained about visual discomfort by drivers and slows both detection and reaction time.  ​​
Advantage of wearing polarised lenses outweighs difficulty of seeing some  polarised LCD display panels  depending on their angle of polarisation.  Unlike some earlier displays  cars with the latest heads up displays work well with Polarised lenses ( as have polarisation along the 45 degree line so that they won’t be impacted by the wearing of polarised specs and sunglasses ).

Sometimes  a contrast tint or regular tint could benefit  in these situations.  Make sure you clean and can see all your mirrors,windows,windscreen for maximum field of vision. The correct prescription and tint avoids  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.

All private and commercial have certain legal responsibilities with respect to 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 as well as private driver has a responsibility to be thoughtful about the way your health may affect you being ‘fit to drive’. This applies to general health as well as the use of drugs and alcohol.
A range of medical conditions, as well as treatments, may therefore impair your ability to undertake your work safely. Common examples include:
Blackouts
Sleep disorders
Vision problems
Diabetes
Epilepsy and seizures
Psychiatric disorders
Heart disease
Conditional licences
In most cases, having a medical condition will not restrict your driving as the licensing authority is able to issue a conditional licence.
In the case of commercial vehicle drivers, the opinion of a medical specialist is generally required for initial recommendation and periodic review of a conditional licence. This requirement reflects the higher safety risk for commercial vehicle drivers and the consequent importance of expert opinion.
 
There are more than 480,000 people aged over 40 in Australia whose vision is currently too poor for them to drive legally. Over three-quarters of these   people could have their vision corrected easily with a pair of glasses or contact lenses. 
 
The examination findings for a driver’s licence determine  Y/N  standard for an unconditional licence is met. 
RMS (NSW) or Access Canberra (ACT)  will decide  – if any – conditional licence might be issued to a driver.

Visual Acuity and Visual Fields Standards for Driving

Private vehicles,Cars, Motorcycles, Light Trucks, Buses and Trucks

A person is not fit to hold an unconditional licence if uncorrected VA in the better eye is worse than 6/12
• A conditional licence may be issued if this standard is met with corrective lenses. • A driver licence will not be issued where VA in the better eye is worse than 6/24. ​ • VA should be measured in each eye separately, without correction.

A person is not fit to hold an unconditional licence if the person’s uncorrected VA is worse than 6/9 in the better eye, or worse than 6/18 in either eye.
• A conditional licence may be issued where this is met with corrective lenses.
​• Taxi Drivers are not licensed by the RMS but by the Department of Transport, but the same standards apply.

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

Visual fields and driving

Private vehicles,Cars, Motorcycles, Light Trucks

Whilst it is ideal to exceed  the relevant  requirement eg 120 degrees or such it cant be considered in isolation,nor for acuity. 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.

 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 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, quadrantinopia likely to impede driving.
3. Field loss is static and unlikely to progress rapidly.

 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 22A 22° 45 – 96
  • Central 22 22° 50
  • Central 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.
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.

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 center 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.

•  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, quadrantinopia 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 important 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

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.

On the other hand, there is much justification for putting anti-reflection coatings on clear lenses to make them 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 wearers 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 wave lengths to increase the penetration of light in fog without reducing the amount of light coming into the eyes at night. It slows reaction time and reduces peripheral vision.

 
driver fatigue

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 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.

The best option for night time 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, obviously the sun is the biggest 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, they have no 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 large potential for improving safety  which is why research in the use of UVA headlamps to enhance night time visibility is ongoing. 

Night time driving is one of the motorist’s most difficult tasks. The risks of having a night time accident on the road is 2 to 3 times greater than during the daytime due to visibilty 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 major 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 surface of the Earth and instantly detect any potential hazards, and  contains a deep learning system sophisticated enough to respond instantly to obstacles and weather hazards. 

If driverless cars of the future detected unusual traffic activity onus is to ensure real humans can access protection services to detect requests of the  auto pilot like cars and override where needed.   Such  online data protection services detect unusual traffic originating from without but likely to encroach into the sphere of the cars safety margin.

In the current era of drivers being in control safety issues arise such as eg if a cyclist was present during a drivers saccade they could be missed as the  door pillars on a car therefore create an even wider blindspot (called windscreen zoning)
Each eye has its own 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 don’t contrast with a scene.
It is especially difficult to spot bicycles, motorbikes and pedestrians during low sun conditions as contrast is reduced and a clean windscreen helps.

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.

DRIVING ASSESSMENT APPEALS
 
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.
Failure to report and choosing to drive may put lives at risk and may result in serious legal and financial consequences,
including loss of insurance cover.

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.

RMS may pending a medical and vision report  suggest you undertake an OT (Occupational Therapist )driving assessment to
determine if the medical condition impacts on 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.

Possible Outcomes of an OT Driving Assessment:
There are a number of recommendations that can result from the assessment. These include:

  •  Fit to drive with no other intervention;
  •  Fit to drive with certain conditions such as a limited distance from home, driving 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 in order to complete the driving assessment or
driving tuition.  
To drive legally with specialised vehicle modifications a person must have the modifications 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

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 cross hatch pattern in the glass. Auto side windows are tempered for safety reasons (windshields are laminated). Tempering induces stress that shows up in clear 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 polarized sunwear, they can appear to be blacked out.  With the growing popularity of polarized sunlenses, automobile manufacturers are being careful to properly align the orientation of their instruments