November 25, 2013

Program opens doors to sight-impaired drivers
The UAB Driving Assessment Clinic can help those with low vision get a driver's license.

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To Dustin Jones, the bioptic driving program at the University of Alabama at Birmingham provides one very important benefit: freedom. Jones, a 24-year-old recent UAB graduate who works in information technology, is a typical young professional.

But he has a congenital eye disease called optic atrophy, which had prevented him from getting a driver’s license at age 16.

“My job is in Hoover,” Jones said. “Without a driver’s license, I would have to live within walking distance or use public transportation. I would be limited in my economic and social opportunities and not really part of the community as I am today.”

Optic atrophy is an inherited condition, and Jones’ vision gradually deteriorated from birth until finally stabilizing when he was about 11. He graduated from the Alabama School of the Blind in Talladega before enrolling at UAB. His close-up vision is fine, but he has issues with distance.

“After a certain distance, it’s kind of like looking through wax paper,” he said. “I can see large objects, but I can’t read a billboard at a distance as well as other people.”

Jones got his driver’s license at 19 with the aid of a bioptic telescope and the UAB Driving Assessment Clinic in the Department of Ophthalmology. The small telescope fits on the frame of a regular pair of glasses, providing the ability to sneak a quick peek at a distant object.

“Bioptic drivers don’t use the telescope all the time to view the roadway when driving,” said Cynthia Owsley, Ph.D., professor of Ophthalmology and director of the clinical research unit. “They use it to spot a faraway object, dipping their heads slightly to bring the bioptic into line, so they can view a distant traffic light or oncoming vehicle. Then they return to viewing the road through their regular glasses.”

Alabama law permits the use of a bioptic telescope, with some restrictions. The driver must meet minimum vision requirements, and an ophthalmologist or optometrist must prescribe the telescope. Drivers then must be approved by a certified driving rehabilitation specialist, such as UAB’s Jennifer Elgin, OTR/L, CDRS.

Elgin teaches drivers how to use the telescope — first while simply walking, then as a passenger in a car and finally behind the wheel. It takes about a year of practice before she signs off on the appropriateness of their application for licensure under Alabama’s bioptic driving rule. Drivers then must pass the usual state driving exam.

Owsley says research shows that most bioptic drivers show good on-road driving performance.

“Research from around the country and the world shows that there is no evidence that individuals with vision impairment who use bioptic telescopes on the road are any more unsafe than are any other drivers,” she said.

Alabama has issued driver’s licenses to persons using a bioptic telescope as an aid since 2005. More than 40 states allow the use of the bioptic telescope in some form. Elgin says she has trained about 70 drivers, mostly young people with low vision — people for whom the ability to get a driver’s license means having the freedom to live a normal life.

“These are people who want to go to work, go to college, who want to take care of their families and do their own errands,” said Owsley. “Driving is the primary way we get around. They just want to be able to drive and live like everybody else.”

“Being mobile opens a lot more doors for you,” Jones said. “With a driver’s license, I can be my own person, and an entire individual. I’m not pigeonholed into a certain class or job or anything.”
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