Licensing Requirements For Bioptic Lens Users

760‑X‑20‑.21

Individuals with suboptimal visual acuity pose a special challenge for assessment and licensing by the Alabama Department of Public Safety (DPS). In its present form, the driver license evaluation and testing process is not sufficient to adequately evaluate a person who requires a bioptic lens to enhance central visual acuity. These applicants will require a certifying exam by an ophthalmologist or optometrist, basic bioptic training, a thorough pretest evaluation to determine if any other cognitive impairment or physical disabilities exist, and then a rigorous road test evaluation. A Certified Driving Rehabilitation Specialist (CDRS) must perform these last two functions.

The following is an outline of the criteria pertinent to the licensing of drivers who require bioptic assistance for improvement of visual acuity. Many other states have bioptic programs, which have been implemented with varying degrees of success. Much of what follows has been adopted from other states as well as the current published research.

1. Visual Acuity (VA) ‑ Must be at least 20/200 in each eye using the carrier lens. When using the bioptic the VA must be at least 20/60. The rationale for choosing 20/60 is that this is the current VA standard in Alabama. Power of the bioptic should not exceed 4X. These measurements will be initially assessed by the person's ophthalmologist or optometrist and then will be verified by the CDRS.

2. Visual Field Requirement ‑ Visual field should extend at least to 110 degrees across the horizontal field and to at least 80 degrees across the vertical field. (Note: Visual fields are to be measured with carrier lens or its equivalent. A bioptic will artificially limit the superior extent of the vertical visual field.) An individual who requires bioptics has compromised central vision and, therefore, it is important that the peripheral vision be adequate. The assessment of visual field should be performed by the person's ophthalmologist or optometrist, subject to confirmation by the CDRS.

3. Other Functional Criteria ‑ The applicant shall be free of cognitive impairment as determined by the Mini‑mental Status Exam (MMSE) of greater or equal to 24 as administered by the CDRS. No significant impairment in the movement of the eyes, head, or neck should be present as determined by the CDRS. The applicant must successfully pass the DPS standard written licensing exam.

4. Written Exam for Licensing ‑ This will be the standard exam administered by the DPS for driver's license certification in the State of Alabama with the exception that accommodations for vision impairment (large print or assistant) will be allowed.

5. Bioptic Training ‑ Once the above minimum criteria have been met, the applicant must produce proof of adequate training completed in a satisfactory manner in the proper use of the bioptic in everyday life. A certificate of completion of said training must be presented to the CDRS before driving‑specific training begins. This training must be performed by a qualified professional skilled in the use of bioptic lenses. A Master List of qualified professionals will be made available. See Appendix A for training guidelines.

6. Driver Training for the New Bioptic Driver ‑ Training will consist of in‑clinic and on‑road training by a certified driving rehabilitation specialist (CDRS). For first‑drivers, training will be longer than for experienced drivers.

7. Bioptic Driving Training Program ‑ Training involves specific issues in the proper use of the bioptic while driving, application of the rules of the road, and all other aspects of general driving principles, as they specifically relate to using a bioptic. Preliminary training will occur in the clinic on basic techniques prior to on‑road teaching.

8. Duration of Bioptic Driver Training ‑ There will be sufficient time devoted to allow for thorough evaluation and training to demonstrate driving competence to the CDRS.

9. Driver Permit ‑ A permit to drive or a waiver letter allowing a bioptic driver to drive while accompanied by a CDRS will be required from the Department of Public Safety prior to initiation of bioptic driver training. The written examination for an operator's driver license must be passed before this permit is issued. This permit/waiver will not be granted until the person provides a form issued by DPS and signed and completed by the person as well as a CDRS stating the person meets the requirements of Sections 1, 2, 3, 4 and 5 above as well as any other criteria established by this rule. This will apply to new drivers as well as previously licensed drivers.

10. Drivers Previously Licensed for Bioptic Driving in Other States ‑ If these applicants meet the visual and other functional requirements for bioptic driving in Alabama and pass the written test, then they will be eligible for a permit/waiver. The applicant then must be evaluated by a CDRS to verify that on‑road bioptic driving skills are intact. Training may not be necessary unless the evaluation reveals skills are substandard, at which time the full training program will be required. These individuals may qualify using their previous out of state license for up to 30 days.

11. Bioptic Training Completion ‑ The CDRS will submit a report to the DPS indicating whether bioptic driver training was completed successfully or not and whether or not the driver meets standards. If the driver meets standards, DPS shall administer the State's standard on‑road evaluation. The driver must successfully pass the State's standard on‑road evaluation before being licensed to drive.

12. Subsequent Evaluation ‑ Minimum requirements for Visual Acuity and Visual Field must be certified annually after initial bioptic licensure by an ophthalmologist or optometrist. An annual review of the driving record should occur. If an at‑fault motor vehicle collision (as indicated on the Accident Report) occurs, the individual must be evaluated by a CDRS to ensure that basic on‑road skills for bioptic driving are still intact prior to resuming operation of a motor vehicle.

13. Restrictions on Bioptic Licensure ‑Drivers with bioptic licensure will only be licensed for day driving. This restriction to daytime driving shall be removed if the license driver:
a. Drives for twenty‑four (24) months without any at‑fault accidents and without any license suspensions;
b. Successfully completes additional evaluation and training specifically designed for night driving from a CDRS; and
c. Passes a comprehensive night driving examination administered by a CDRS.
The driver must submit written documentation from a CDRS stating they meet the qualifications for removal of the day driving only restriction.

Evaluation of Bioptic Licensure Program ‑ DPS will establish a database of all drivers licensed for bioptic usage and conduct a formal evaluation of the program two years after its inception, and then again two years later, in order to meet the Department's mission of protecting the safety of Alabamians. DPS will conduct process evaluation of the program and evaluate safety record of drivers relative to the general population of drivers of similar age. The Medical Advisory Board shall review results.

Conflicting Regulations ‑ To the extent this regulation conflicts with current DPS regulations this regulation shall prevail.