AutO&Mobility: safe driving with a visual impairment in a European setting

Background: European legislation prohibits driving a passenger car when visual acuity is below 0.50 or visual field is less than 120 degrees horizontal. However insufficient acuity might be compensated using a bioptic telescope, and people with hemianopia might learn to use compensatory saccadic eye movements to improve fitness-to-drive. Methods: Several scientific studies have focused on introducing new rehabilitation programs in the Netherlands to enlarge the mobility options of visual impaired people. Melis-Dankers et al (2008) and Kooijman et al (2008) concluded that bioptic driving could safely be introduced in a European setting, provided that a close collaboration and education of relevant parties exists. Metting et al (2013) showed that nystagmus is no contraindication for the bioptic driving program. De Haan et al (2014) showed that a proper compensatory eye-movement training could compensate for the effects of hemianopia. Results: Since 2009, Royal Dutch Visio offers a nationwide rehabilitation program for visually impaired people who want to improve or regain independent mobility, called AutO&Mobility. The program does not focus on specific vehicles, but uses a holistic approach to mobility. Over 1200 participants entered the program so far. Vehicles vary form cars, slow motorized traffic, mobility scooters, mini-cars to even tractors. About 200 participants succeeded in obtaining or regaining a driving license for cars. Young people with nystagmus proved to be especially successful. Participants that did not meet the required visual functions for driving a car were offered mobility alternatives such as low-speed vehicles or public transport support. Conclusion: The holistic approach to independent mobility proved to be successful in a group of visual impaired people. Royal Dutch Visio developed a short but mandatory national training program for driving instructors, optometrists and driving officials who deal directly with participants with low vision. In 2016 we will organize an international training course for professionals