Low-Vision Bioptic Driving Services in Indiana

Low vision can present a variety of difficulties that can impact safe driving. Bioptic systems combine prescription eyewear with a small telescopic system. The bioptic telescope aids in quick spotting of detail for the visually impaired patient. The bioptic system is determined by your low vision specialist. People with mild to moderate central vision loss but with good peripheral vision may be able to drive in Indiana by using these special driving lenses. The small telescope lens fit onto special eyeglasses, and when the person looks through the lens, the sharpness of objects in the distance is enhanced so identification and recognition can occur.

Indiana has a wonderful bioptic driving program that many states have used as a model. The program, which was approved by the State's Bureau of Motor Vehicles (BMV), involves a team of professionals working together to ensure that bioptic drivers learn to drive safely through a well-coordinated process of evaluation and training. 

Bioptic driving is a method of adaptive driving in which the low vision driver uses their general vision in combination with quick, intermittent spotting through the telescopic lens. The low vision driver will learn to quickly glance through the lens to search for important details in the driving environment such as street signs, traffic lights and far distant objects. Bioptic driving requires careful fitting of the system followed by extensive training in both the use of the bioptic telescope and behind-the-wheel driver education.

The process for bioptic telescope for indiana is outlined below:

1. A Low Vision Examination by an eye care specialist that has a specialty in low vision rehabilitation (either an ophthalmologist or optometrist).
2. Prescription of the Bioptic System
3. Fitting and Training with the Bioptic system in the eye care specialist's office
4. Driver Rehabilitation Evaluation by a Driver Rehabilitation Specialist who is recognized by the state of Indiana to teach Bioptic Driver Training 
5. Obtain a Driver License Permit from BMV to be used only with the Driver Rehabilitation Specialist who is recognized by the state of Indiana for the on-road training
6. Behind the Wheel Driver Training. The BMV requires that a person with Bioptic System be trained for a minimum of 30 hours or more with a Driver Rehabilitation Specialist who is recognized by the state of Indiana to teach Bioptic Driver Training.  If you are a candidate for night driving, this will be addressed during your training.
7. BMV Driver's Test by a BMV examiner that includes an extended behind-the-wheel test.
8. Licensure is maintained by submitting an annual vision exam report to the BMV by the eye care specialist who will determine if the driver continues to meet the state's licensing requirements. When the license is due for renewal, the driver is required to return to a license branch to renew their driving privileges. A driver re-evaluation may be requested by the eye care specialist or the state if the person has a history of accidents. 

More details about the process

The bioptic driving process in Indiana begins with a thorough examination by a low vision specialist who will either be an ophthalmologist or optometrist who specializes in low vision rehabilitation. This doctor will document the person's medical and driving history. Secondly, the doctor will determine if the person meets the BMV's visual requirements and has good eye health. In Indiana the visual acuity requirements are no less than 20/200 in one eye and an ability to read the 20/40 line with the bioptic system. Additionally, the patient must demonstrate 120 degrees of horizontal visual field and an ability to discriminate traffic signs and signals. The doctor will determine whether the person has the potential to participate in the Indiana bioptic driving program.

The next step would be for the low vision doctor to evaluate and prescribe a specific Bioptic System for the person. If the person continues to meet the criteria and chooses to go forward, then fitting and training sessions with the Bioptic System will take place in the eye care specialist's office.  The person must learn many new strategies for using a Bioptic System such as the simple mechanics of using the bioptics, the different spatial relationships with the bioptic, new visual search patterns and the technique of spotting.

When the low vision doctor feels that the driver is ready for the next step, he or she will refer the person to a driver rehabilitation specialist for a specific bioptic driver evaluation. Our staff of driving specialists are Occupational Therapy Practitioners (OT) who are experts at task analysis for the activity of driving as well as experts at planning intervention strategies to improve a person's driving skills. An appointment will be made with us and we will come to the client's house to complete the initial low vision/bioptic driver evaluation. This evaluation will generally take between 1-2 hours.

The OT driver rehabilitation specialist will develop a profile of the driver, review medical history and medications, perform some clinical testing as necessary for physical and cognitive skills and observe the driver's proficiency in using the bioptic lens.  Proficiency is usually evaluated in one of our training vehicles with the bioptic driver being a passenger and the specialist driving the vehicle. The driving specialist will observe the person's ability to identify road signs, road markings and other detail in the near and distance driving environment. The specialist will determine if the person's skill level is adequate to be in the special driver training process.

If the person is deemed ready to begin in-vehicle work, the driving specialist and low vision doctor will send a request to the BMV's Medical Advisory Committee to consider granting the person a driving permit from the BMV. They may require the person to take a written test. If the BMV agrees that the person has potential to become a safe bioptic driver, they will grant approval for a "driving permit for training purposes only" that will be good for one year from the date issued.

Once the person has received the driving permit, driving is only permitted with the driver rehabilitation specialist in a dual-controlled vehicle. The date and length of in-vehicle training can be scheduled to coincide with the person's work schedule. We will also agree to a location for pick-up and drop-off.

The time for this entire process can ideally take between 3 to 6 months from the initial vision examination and driver training to taking the BMV behind-the-wheel test. There are factors that can affect this timetable such as securing funding for the bioptic system and or driver training through Indiana's Bureau of Vocational Rehabilitation. This program has its own client eligibility requirements for determining services they will fund. Other factors may include the person's availability to participate in the extensive driver training or finding availability on the busy driver rehabilitation specialist's schedule.

If a person chooses to proceed with this process, he or she must understand that the driver training is not an option but a required step in the process. Our staff will do what we can do accommodate the person's needs and schedule. Any person entering this process must understand that the driver training is extensive and intensive. The in-vehicle training is crucial to a successful outcome as the low vision/bioptic driver is taught to drive safely using the bioptic system. The starting point of the training will be dependent upon the person's experience level. For example, if the person had driving experience before needing a bioptic system, then it would probably not be necessary to instruct this person in the basics of operating a vehicle. If the person has no driving experience, then initial driver education knowledge must be taught and basic vehicle operation practiced.

Our staff will structure each lesson with specific goals geared toward your needs and progress. Our staff is very adept at breaking down the driving task into its simplest form and teaching simple steps first. The first lessons may be in off-road or low traffic areas and as the driver demonstrates confidence and competency using the bioptic lens and carrier glasses, he or she will be progressed into more traffic and more complexity. The Bioptic driver needs to learn to be ever attentive to the task of driving and a master of multi-tasking.

Unique driving strategies will be taught and practiced in various traffic and speed conditions. Mary Ellen Keith, one of our own OT Driving Specialists, coined a strategic term for handling visual search called "coast-scope-clues." The driver is taught to coast (no gas and no brake) at certain strategic times while looking into the telescopic lens, and then come out and search for clues.

Driver education for a bioptic driver is quite different from an average driver education class in high school or lessons taught by a commercial driving school. A low vision/bioptic beginner driver learns much differently and with different visual and thinking strategies. For example, bioptic beginner drivers often over-steer the vehicle so they must be taught to scan further ahead in the driving environment for better vehicle positioning and lane control.

Whether the client is a new or experienced driver, driver training will cover all traffic conditions in the person's own living environment that are familiar and unfamiliar. Driving at different times of the day may show issues that will need to be addressed with other aids or devices. For example, if glare is an issue at certain times of the day, then recommendations may be made for special glare lens, shading of the window or other solutions.

Obtaining a driver license cannot proceed until the low vision/bioptic driver has completed all driver training deemed necessary by the driver rehabilitation specialist. This may be completed in the minimum 30 hours required by Indiana or by additional hours as determined by the driving specialist. When the driving specialist determines that the driver has mastered all skills necessary in all driving environments, she will accompany the driver to a local license branch office to apply for an Indiana operator's driver license. An extended road test will be completed with a state license examiner.

Our Driving Specialists are happy to answer any question that one may still have so please contact us by telephone or email. If you or a loved one is finding difficulty with driving skills due to vision difficulties, we have occupational therapy practitioners on staff who are well-known specialists in driving in Indiana and who have the knowledge and skills to help you.