In the Driver's Seat: Chuck Huss - Rehabilitation Specialist Description of graphical content is included between Description Start and Description End. Transcript Start [Music] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. [Music face out] Fade to black. [ Music ] [ Title start: ] Description Start: Title: In the Driver's Seat A Conversation with Chuck Huss Consideration for Students: The Decision to Drive Description End: [Title end:] Cindy Bachofer: Students have an option for both either a hand-held telescope or a head-born unit. What are some pros and cons to consider in those two? Chuck Huss: Okay. Cindy, let's first take a look at... hand-held monocular telescopes. Give some of the pros, and then versus, some of the cons for those. Some of the pros are, is that most hand-held type of devices that are prescribed through a optometrist or an ophthalmologist that practices clinical low vision, are usually affordable in the range between $100 and $200. Okay. And the nice thing is depending upon the age of the individual, the maturity of the individual, if by some chance the device becomes misplaced or lost, it doesn't take a whole lot of funds to replace it. Okay? Versus a head-born devices. These devices, the pros of it, is it allows you to extend that individual's distance awareness of objects or forms... that otherwise they simply have to get closer to, or use what we call approach magnification to detect and decipher what it is in their distance environment. The cons are, is that because a hand-held telescope, if the individual doesn't wear a pair of regular refractive corrective lenses, or let's say they have contact lenses, a hand-held telescope is held right up against the orbit of the eye. And in most instances, individuals who utilize those, often times find that by closing the other eye and placing the device right up to the orbit of the eye will block out any or all extraneous light. So, that primarily when you're using a hand-held distance telescope, the devices are used on stationary type of tasks, whether it's from a sitting position, or a standing position. Okay? And you can use for longer periods of time. Now, grant it you can also use it as a passenger in a vehicle for extended periods of time, but once you're behind the wheel, that creates a different story. Now for head-born systems, again, you have the same... nearness solution, like you have hand-held devices. The advantage is, is that the use of a head-born system allows you to go from unmagnified vision, in your larger carrier lens, to magnified or telescopic viewing, okay, through the miniature telescope within a fracture of a second. The advantage there, too, is, is that you have access to your-- use of your paramacular and your peripheral vision, because there's distance-- linear distance between the front of your eyeball and the front part of the carrier lens, or the front of the eyeball and the back of the telescopic portion, the ocular lens of the telescope. This linear distance is referred to as vertex distance. Okay? And as long as there's physical space there, even when you're dipping down into the telescope, you can maintain gross awareness of the space around you. Remember that, when you're using a head-born system for vertical spotting purposes when driving, those fixations are kept to between 1 and no more than 2 seconds, per fixation. Okay? So that the greater majority of your driving is done through your carrier lens system. Okay? With both systems, you will have-- some of the cons of both is that you'll have a restricted field of view, depending upon magnification. In most instances, the greater the magnification the smaller field of view. One way that it can be made bigger, as far as your magnified field, is just being prescribed a larger head-born unit, or a larger hand-held device. Bachofer: Higher powered? Huss: Higher powered, pardon me. Bachofer: Tell me a little on the difference between driving training for someone with typical vision, and then someone who has low vision. Huss: Okay. Typically, a person with normal sight who goes through a- a course of instruction in high school; may be required at the present time to complete a program from anywhere 30 hours, on up, of classroom. But as far as behind the wheel training, it used to be as low as 6 hours, but usually no less than 10 hours, now, for a normally sighted individual. In contrast, a person with a mild to moderate level of central vision loss, but full field's view; and a person who never expected to be afforded the opportunity to explore driving, will probably need a much more greater number of hours, not only in classroom, but potentially passenger in car, and behind the wheel. In our particular program, as an example, in the state of West Virginia, we use a... legislative program that requires 30 hours of classroom, 30 hours of passenger in car, 30 hours behind the wheel. Okay? Our testing process for driver licensure is also contrasting. While a normally sighted individual will complete their, quote, on road test or actual in car test, behind the wheel, in sometimes as quick as 5 to 10 minutes around a-- what we refer to as a driver range type of course-- we often times require that an individual with a known mild to moderate level of central vision loss to participate in an actual on road test. In fact, in about 50% of the states that now permit bioptic driving, you are required, by law, to participate in a longer, more challenging test, on road, to acquire the driving privilege. And even then, the privileges are going to be restricted. Bachofer: And that will also depend state to state. Huss: You know it'll vary from state to state since driving licensing is a state regulated function. Bachofer: If a driver is licensed in one state and wanting to drive in another state, what- what can be the... information they need to be aware of state to state? Huss: Be apprised that all individuals who are granted restrictive driving privileges, by their respective licensing jurisdiction or state, will be permitted to cross state lines, provided there isn't a restriction on their driving privileges that would otherwise prevent them from doing so. For example, if you're licensed in Connecticut, you may be able to drive during daytime hours all the way to California and back, as long as all driving is done by you during daylight hours. Often daytime driving privileges refer to the fact that you start your driving 30 minutes after sunrise to 30 minutes before sunset. So, at certain times of the year, you will be permitted to drive longer. Usually during the summer months. There is a federal mandate that will allow an individual, licensed in one state, to drive across state lines, even though the other state may not permit a person like yourself, with a certain level of vision loss, okay, to be licensed originally in that state. But you can drive, in and out, whether it's for leisure or recreational purposes, for work purposes, etc. There are only two states that I'm currently aware of that strictly prohibit the use of the telescope; and that is the state of Utah and the state of Connecticut. Yet, both of those two states do allow individuals with mild to moderate levels of central vision to be licensed. Utah down to 20/100; Connecticut down to 20/200. Yet, without the use of a prescription bioptic lens system. Bachofer: It's possible that low vision drivers would have some restrictions placed on their license. What would be some examples of restrictions? Huss: You're correct, Cindy. In most instances, the individuals, despite the fact that they may be screened, trained, assessed, and... undergo a separate and more comprehensive on-road test; chances are, for at least one year-- in the state of West Virginia it's for three years-- they're going to have license restrictions placed on their license. Usually the first and most common restriction placed on bioptic drivers licensees is the daytime only restriction, which means they're permitted operate a motor vehicle, a private vehicle-- usually of a certain weight. In our state it's 8,000 pounds. In other states, it's usually 10,000 pounds, or less. But it's a private vehicle. And... the driving times usually begin 30 minutes after sunrise to 30 minutes before sunset. So, in those types of situations, usually the individual, usually in the summer months of the year, are driving for a longer period of time. And again, remember, with that daytime restriction, they can drive from their point of residence, all the way across country, stopping intermittently, okay, when it becomes dark time. And then, resume the next day etc., etc. In addition to the daytime restriction, it's not uncommon to have a restriction as far as speed. For example, in our particular state, especially with all novice drivers-- by novice, we're talking about a driver who may be adequately screened and trained, but someone who has never held a license, it's not uncommon to have a restriction of sixty- 65 miles per hour, or less. Some states require a speed restriction, sometimes even lower than 65, and sometimes not access to interstate driving that first year. Most states, if not all, have an appeal process. So, if their license is restricted, possibly to daytime only, speed, type of roadway, distance from home, sometimes it's a 50 mile radius, they're usually permitted to appeal to DMV, after a year of not at fault accidents and... violation free driving after one year, they can appeal. Sometimes with that appeal- the appeal, they are required to come back and participate in additional training and testing, along with updated vision exams. So, in our particular state, on an annual basis, the annual anniversary date of their licensure, they are required to submit, to the driver licensing authority, an updated complete clinical low vision exam, including vision field testing. Okay? But usually, when a person comes back for additional training, let's say, from no nighttime driving to an appeal to get that nighttime driving restriction removed. In our particular state, we require an additional 15 hours of training. Five in the classroom, five passenger and car, five behind the wheel; along with an actual on-road test under nighttime conditions. And that's something that's usually common among states that allow you to appeal to get that restriction removed. There's any number of restrictions that can be placed on your license. For instance, another common one that we put on for young, novice drivers-- I'm talking about ages 15, 16, and sometimes 17, is that, they drive with another licensed driver, 21 years of age or older, usually a parent or a guardian, for the first 4 to 6 weeks of driving, and they keep a ledger. We think it's a good idea. Okay? So that they've had adequate observed driving and feedback, from an experienced driver, before they start driving out on their own. Sometimes we will also suggest some self-restrictions. For instance, driving during low peak driving times, from 9 to 11, 1 to 3. Okay? Or let's say, when you're driving familiar routes only. Or when you drive an unfamiliar route, maybe driving that particular route as a passenger-in-car, the first time or two around, before you set out to do it on your own, or with another individual in the car on the right side of the vehicle. So, those are some of the common restrictions we have. Bachofer: And I've heard weather conditions comes up a lot. Huss: Yes, good point. Good point. A lot of times the individuals will say you're permitted to drive during daytime conditions, including inclimate weather, but let's be sure that we define inclimate weather. From a standpoint of low vision drivers, what we indicate is, when adverse weather or inclimate weather gets to the point where the low vision driver is unable to see other road users, pavement markings, or traffic control devices, such as stop signs, traffic lights. Okay? Things like that. Then that individual should pre-plan, in advance, whenever possible, to get someone else to drive, or at least to stay off the road during those periods of time. [Music] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. [Music face out] Fade to black.