Driving Rehabilitation Strategies for People with Low Visual Acuity

Driving Rehabilitation Strategies for People with Low Visual Acuity

Grabbing your car keys to run a quick errand is something many people take for granted. That’s why losing the ability to drive can have such a profound impact on your sense of self and independence.

The aging process brings changes in visual acuity and mental agility that can impact the ability to drive safely. If you notice any changes to your vision, visit an eye doctor right away to check your sight.

When does low vision affect driving?

Age-related vision loss is a common concern for many seniors, but sometimes it’s hard to discern. How do you know when vision loss is impacting your ability to drive?

First, you should visit an eye doctor to check out any changes to your vision. Also, think about these questions before you get behind the wheel:

Signs of a loss of peripheral vision

  • While you’re driving, does it seem like pedestrians are sneaking up on you? Does it seem like people are sneaking up on you when you’re not driving, for example at the grocery store?
  • Do you have difficulty making turns, such as hitting curbs or not seeing the edge of the road well? Are you having close calls while merging or changing lanes?
  • Is backing out of the garage difficult? Have you hit the side of the garage?

Signs of reduced visual acuity

  • Are you having difficulty seeing traffic lights or traffic signs?
  • Do passengers complain that you are following other vehicles too closely?
  • Is making a left-hand turn uncomfortable?
  • Do you have increased difficulty seeing the television?

Fun fact: Don’t worry about not being able to read street signs. It is not a good indicator of reduced visual acuity, as the print on street signs is small, and contrast is poor.

Driving rehabilitation strategies

Vision changes do not necessarily spell the end of driving. There are many driving rehabilitation strategies and tools a person with vision loss can use to continue driving.

Driving rehabilitation specialists help individuals develop strategies to manage a wide variety of situations.

It’s important to have good light management while driving. Yellow-tinted wraparound sunglasses (such as Cocoons) are recommended, though some people find that gray or brown filters work best for them. Regardless of what tint you prefer, filtered sunglasses can help to manage spikes of light and improve your ability to see.

Driving in low light or rain is more difficult to manage. Often, the best option is not to go out that day. But if you’re caught in an unexpected rain, choosing to wait it out or taking a route home that is slower or has less traffic are two strategies to help manage the reduced visual acuity caused by low light and rain.

If your vision has gotten to a point where your eye doctor tells you to stop driving or alerts you that giving up your car keys is on the horizon, there may be another option.

The Spectrios Institute for Low Vision is one of the few accredited low-vision rehabilitation clinics that helps people retain or regain their driving privileges. By testing your visual acuity, potential, and peripheral field, the optometrists at Spectrios can determine if you meet the minimum acuity standards set by the state of Illinois.

If your vision meets the standards for driving, Spectrios will submit a vision specialist report (VSR) to the Illinois Secretary of State and you will receive an original copy. All people with vision impairment must have their vision checked and the VSR submitted annually.

If your visual acuity falls below the acuity standards, you may be able to use prescriptive devices. Specialists often prescribe custom bioptic lenses, which are like binoculars that are mounted on eyeglasses. In Illinois, bioptics can be considered if one can achieve 20/40 acuity through either a 2.2x standard telescope or 3.0x wide angle telescope. Each year, the Spectrios Institute for Low Vision completes VSRs for approximately 100 drivers with bioptics.

Bioptic lenses require training. The individual must become comfortable using the lenses prior to driving a vehicle. It is highly recommended that the person work with a driving rehabilitation specialist who can provide strategies for safe driving. Bioptic lenses are also useful for watching television and a variety of other situations.

Unfortunately, no special devices or optical tools are currently permitted for those with constricted visual field. If your peripheral field standards do not meet the minimum requirement, you must discontinue driving.

If a person just barely passes the visual acuity or peripheral field tests, or if an individual elects to pursue driving with bioptics, it is recommended that a driving rehabilitation specialist conduct a behind-the-wheel evaluation as well as defensive driving training.

Illinois Minimum Acuity Standards (best corrected)

  • Unrestricted: 20/40 binocular
  • Daylight driving only: 20/41 to 20/70 binocular
  • Failure: 20/71 or worse binocular
  • Right and left outside rearview mirrors are required if one eye is 20/100 or worse

Illinois Minimum Peripheral Field Standards

  • Binocular: total temporal peripheral field of 140 degrees or greater
  • If less than 140 degrees, at least one eye must have 70 degrees temporal and 35 degrees nasal, with both left and right outside rearview mirrors required
  • Failure: if neither eye has 70 degrees temporal and 35 degrees nasal


If you have any questions or concerns regarding driving with vision loss, the team at Spectrios looks forward to helping you! You can schedule an appointment by calling Spectrios Institute for Low Vision, 630-690-7115, spectrios.org.