The Department of Motor Vehicles (DMV) in most states maintain a 20/40 vision requirement to acquire or renew a driver’s license. In recent years, however, multiple states, including California, Ohio, Utah and Oklahoma, have required, and continue to require, eye care specialists to sign off on an exam form for a person’s license to be renewed, especially for low-vision individuals and elderly drivers. With this in mind, optometrists well-versed in delivering the difficult news that driving is no longer possible, provide tips on how to do so.

• Address it with simplicity. “I simply tell the patient they are no longer visually qualified to drive, and I encourage them to retire from all driving immediately,” explains Mark Wilkinson, clinical professor of ophthalmology at the University of Iowa and medical director of UI Optical. Dr. Wilkinson advises up to four patients a month and is frequently sought by families who don’t want to be the ones to take the keys away. If appropriate, Dr. Wilkinson says he advocates for the patient’s state DMV to give them a behind-the-wheel test.
• Approach it empathetically. Eli Peli, O.D., professor of ophthalmology at Harvard and author of the book “Driving with Confidence: A Practical Guide to Driving with Low Vision” says. “When patients come to me, they were already told that they should stop driving. They come to me to see if I can do something to change reality. The secret to doing it [the difficult conversation] right is to convince the patient that you really care about them and the severe impact driving cessation will have on them. The secret to convincing them of that is simply to really care. I say that good clinicians learn that from their mothers.”

Dr. Wilkinson notes that the provider is naturally concerned that they will get a reputation of taking people’s driving privileges away, which could have a negative impact on their practices, but that, “our patients come to us to receive the best care we can provide them… Not telling someone they are no longer visually qualified to drive puts that person at personal risk and the general public at risk if they have an accident.” OM