Doctor, Can I Still Drive? Part 2 of a Conversation with Richard Hom, OD, MPA

Head shot of Richard Hom, OD, MPH. He is facing forward, wearing glasses, and smiling

Guest blogger Dr. Richard Hom has served as a low vision specialist for the Permanente Medical Group’s Golden Gate Service Area of three hospitals. Dr. Hom holds a Doctor of Optometry degree from the University of California and a Master’s degree in Public Administration from San Francisco State University. You can follow Dr. Hom on Twitter @GrandRounds4ODs.

Previously, Dr. Hom introduced the topic of driving with vision loss, including the strong emotions and fears experienced by adults and older adults who may be facing the loss of driving privileges. This week, Dr. Hom presents scenarios that can best accommodate the driving objectives of all concerned: yours, your family, your doctor, and the motor vehicle department.

“Doctor, I am a safe driver, but the driver’s license department says I have failed my vision test for renewal!”

Working with Your Eye Doctor and the License Renewal Process

This is a statement I hear frequently from my patients. About a dozen times a week, I do evaluations to renew an older patient’s driver’s license. My best advice to patients is always to work with your eye doctor if you believe you can still drive. Here’s an approach that I practice and recommend:

First, look for an eye doctor who is comfortable with the rules and regulations that govern his or her state driver’s license department and/or division of motor vehicles (DMV). Don’t assume that every eye doctor is well-acquainted with these driving laws. I make certain to explain the three-stage appeals process for California driver’s license (since I practice in California) to my patients, as well as the documentation that is required to demonstrate safe driving practices.

(Note: BiopticDrivingUSA provides helpful information about state-by-state laws governing bioptic driving, how bioptics help with driving, and frequently asked questions about bioptic driving rules and regulations.)

Second, I check each patient’s vision in both bright and dim lighting, since I’m aware that some patients are able to see better in daylight, while others may be able to see better at night. During my exam, I will even shine a light toward the side of my patients’ eyes to simulate approaching headlights.

Third, I make it clear to my patients that it is not my role or responsibility to approve or disapprove the DMV application – my role is simply to deliver accurate eye and medical information, along with my recommendations. However, since my recommendations carry weight with the DMV, I will explain my findings clearly to each patient.

Finally, I complete the DMV form and explain each of my responses to ensure that what I wrote on the form is not a secret and is clearly understood by my patient. The last thing I want my patient to feel is that I betrayed him or her by reporting something negative to the DMV without their knowledge.

The partial loss of sight can be disconcerting and even frightening, since vision loss is usually accompanied by a host of new and unfamiliar emotions. You and your eye doctor, however, can make this process bearable – and even satisfying – if you work together to accommodate the objectives of everyone involved in the driving authorization process: you, your family, the doctor, and the motor vehicle department.