Driving and Visual Problems
After Stroke or Head Injury
Management of Visual Problems Related to Driving
Driving is often a concern for the patient recovering from a head injury or stroke. While vision is only one of many areas of concern, it is an important one. We evaluate history, threshold visual fields, visual acuity, refraction, binocular vision, saccades and pursuits, depth perception, eye health, tolerance to light and glare, visual neglect and visual perceptual skills. We find that evaluation of visual spatial relationships and visual figure ground are a particular concern in right brain injury patients returning to driving. Patients with significant problems, will also benefit from additional evaluation and behind the wheel training at one of the several driving rehabilitation programs in the region. We try to work closely with these programs to insure a safe return to driving.
TBI patients do not always appreciate their new deficits and may assume their driving skills are adequate when significant safety risks may still be present.
The decision whether a patient may safely return to driving should be a team effort. The team dealing with the patient will vary but the following are some of the professionals who may be involved in a team decision; driving rehabilitation specialists, the family physician, neurologist, physiatrist, neuro-psychologist occupational therapists, physical therapist, optometric low vision specialist, neuro-ophthalmologist, family and the patient.
When a patient's visual problems have been addresses successfully and other health or cognitive problems do not preclude driving, a referral to a driving rehabilitation specialist may be indicated. The driving rehab specialist evaluates the patient both in and out of the car. Behind the wheel evaluations may quickly uncover weaknesses not seen in the clinical setting or confirm the patient's ability to work towards driving. A series of behind-the-wheel training sessions may be required before the patient is released. Only the small group of patient that can demonstrate safe driving will return to driving.