Characteristics of on-road driving by persons with central vision loss: Learning to drive with a bioptic telescope

Abstract

There is limited research on the driving performance and safety of bioptic drivers and even less regarding the driving skills that are most challenging for those learning to drive with bioptic telescopes. This research consisted of case studies of five trainee bioptic drivers whose driving skills were compared with those of a group of licensed bioptic drivers (n=23) while they drove along city, suburban, and controlled-access highways in an instrumented dual-brake vehicle. A certified driver rehabilitation specialist was positioned in the front passenger seat to monitor safety and two backseat evaluators independently rated driving using a standardized scoring system. Other aspects of performance were assessed through vehicle instrumentation and video recordings. Results demonstrate that while sign recognition, lane keeping, steering steadiness, gap judgments and speed choices were significantly worse in trainees, some driving behaviors and skills, including pedestrian detection and traffic light recognition were not significantly different to those of the licensed drivers. These data provide useful insights into the skill challenges encountered by a small sample of trainee bioptic drivers which, while not generalizable because of the small sample size, provide valuable insights beyond that of previous studies and can be used as a basis to guide training strategies.

Low Vision and Driving

“…For the purposes of driving, people look through the carrier lenses under the BTS mount for general driving-90% to 95% of the total driving time-and then look up into the miniature telescopic lens unit(s) using a simple synchronized head and eye vertical drop technique to discern detail, color, or activity. [29][30][31][32][33][34][35][36][37]40,41 The BTS permits the trained user a rapid interchange between spectacle and telescopic viewing within a second or two per fixation. 29,30 The use of the BTS provides information to the driver regarding object identification in the distance.…”

“…Extensive training with the device is paramount to the success for implementation when participating in functional or community mobility tasks such as driving. [29][30][31][32][33][34][35][36][37] This can include training programs that help users hone distance viewing skills such as the forward scan and lateral head and eye scanning and provide education to patients about the need to maintain a 3-to 4-second following distance. [29][30][31][32][33][34][35][36][37]…”

“…[29][30][31][32][33][34][35][36][37] This can include training programs that help users hone distance viewing skills such as the forward scan and lateral head and eye scanning and provide education to patients about the need to maintain a 3-to 4-second following distance. [29][30][31][32][33][34][35][36][37]…”

“…The BTS is positioned in the upper part of glasses with a person's prescriptive correction, often referred to as the carrier lens. For the purposes of driving, people look through the carrier lenses under the BTS mount for general driving—90% to 95% of the total driving time—and then look up into the miniature telescopic lens unit(s) using a simple synchronized head and eye vertical drop technique to discern detail, color, or activity 29–37,40,41. The BTS permits the trained user a rapid interchange between spectacle and telescopic viewing within a second or two per fixation 29,30.…”

Professional reasoning of occupational therapy driver rehabilitation interventions

“…Driver‐trained occupational therapists are characteristically advanced practitioners requiring postgraduate training given such work requires complex professional decision making in a higher risk, highly skilled area of practice. Research into driver rehabilitation interventions primarily consists of the effectiveness of car adaptations and modifications (Lowe et al, 2014; Unsworth & Baker, 2014), computer‐based driving simulator training (George et al, 2014), off‐road training (Crotty & George, 2009; Frith et al, 2017; Ross et al, 2018), on‐road training (Golisz, 2014; Unsworth & Baker, 2014), personal adaptive devices (Golisz, 2014; Wood et al, 2016), physical fitness programmes (Gaudet et al, 2016; Golisz, 2014), and psychosocial support (Golisz, 2014). There is a scarcity of research exploring the clinical reasoning processes for why interventions are recommended from a driver‐trained occupational therapist perspective.…”