13478 Health Library | Health and Wellness | Wellmont Health System
  • Driving With Macular Degeneration: Is It Safe?

    IMAGE If you have macular degeneration, you may have struggled over whether to continue driving.
    The disease causes blurriness or a blind spot called a scotoma in the center of the field of vision. The size, density, and location of a scotoma determine whether you can see well enough to drive safely. Although you may still have sharpness of vision (acuity) that will allow you to legally keep driving, there are some factors to consider before you get behind the wheel.

    Knowing When It's Okay to Drive

    To drive safely, you must not only meet the visual acuity requirements for having a driver's license, but also have good reflexes and a good field of vision, so that you can react to an unexpected event, such as a child darting from between parked cars.
    You do not have to see everything perfectly in focus. If you are in doubt, test yourself. Go out with a family member or friend on a bright day when traffic is light, and test your ability to turn, avoid obstacles, and park.
    Many people who are able to drive during the day may have difficulty driving at night, because of reduced contrast sensitivity. It is the most common complaint of driving with macular degeneration, and it is related to the severity of the scotoma.
    As a driver, you need to put safety first. Consider avoiding driving challenges such as darkness, poor weather, or driving in unfamiliar places. Avoid situations that you have difficulty with.

    Optical Aids

    There are some treatment options that may help you drive longer. One is the autofocus spectacle-mounted telescope. It will not compensate for an inability to see cars and people, but it can help drivers read signs. One model flips down over the top of eyeglass lenses, and the object viewed through it comes into focus automatically. Using these prescription telescopes, also called bioptics, requires training at a low-vision clinic. If you are approved to use bioptics, it is important to use them everytime you drive.
    In 2010, the Federal Drug Administration approved Implantable Miniature Telescopes. The implants improve vision in some patients with end-stage age-related macular degeneration. Although evidence shows the implants improve visual acuity for up to 2 years, the it is not known if the improvements affect driving ability.
    In addition to optical aids, many organizations have educational programs for drivers with visual impairments. People who have taken the course learned more about safe driving, how age can affect skills, and when to get off the road.

    Driver's License Requirements

    Most states, but not all, require that vision be corrected to 20/40 in the better eye for obtaining an unrestricted driver's license.
    In addition, most states will also accommodate people with low vision by issuing restricted licenses that limit driving to daylight hours. Some states offer restricted licenses that allow people to drive only to certain locations. If you are unsure about the restrictions where you live, contact the motor vehicle office in your state.

    Families and Other Support

    Being unable to drive is a loss of independence. It is common to struggle with this change. Start thinking about the options in your area that will help you process this change if the time comes and you can no longer drive.
    Friends and family may be your first option when you need to get around. When they are not available, you may find drivers through support groups and volunteer organizations. You may also want to look into taxi cabs, public transportation, shuttle buses, and vans.
    Remember, if you have any decrease in your vision, be sure to talk to your eye doctor before driving to keep you and everyone else on the road safe.

    RESOURCES

    American Academy of Ophthalmology http://www.aao.org/

    Macular Degeneration International http://www.maculardegeneration.org/

    CANADIAN RESOURCES

    Canadian Association of Optometrists http://www.opto.ca/

    Canadian Ophthalmological Society http://www.eyesite.ca/

    References

    Age-related macular degeneration. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated September 5, 2012. Accessed January 4, 2013.

    Bioptic Driving. Bioptic Driving Network website. Available at: http://biopticdriving.org/countries/USA.htm. Accessed January 7, 2013.

    Bioptic Driving Network. Bioptic Driving Network website. Available at: http://biopticdriving.org/index.htm. Accessed January 7, 2013.

    Driving When You Have Macular Degeneration. US Department of Transportation National Highway Traffic Safety website. Available at: http://www.nhtsa.gov/people/injury/olddrive/Macular/Index.html. Accessed January 7, 2013.

    Hudson HL, Stulting RD, Heier JS, et al. Implantable telescope for end-stage age-related macular degeneration: long-term visual acuity and safety outcomes. Am J Ophthalmol. 2008;146(5):664-673.

    Owsley C, McGwin G Jr. Driving and Age-Related Macular Degeneration. J Vis Impair Blind. 2008;102(10):621-635.

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