BIOPTIC DRIVERS
FREQUENTLY ASKED QUESTIONS
ABOUT BIOPTIC DRIVING
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Case by examples continue to be allowed dispite their national assessing fitiness to drive guidelines saying bioptic cannot be used for licencesure.
There are formalised programs in Quebec and Ontario with services on case by case basis In Manitoba, Saskatchewan, and British Columbia.
Saskatchewan “does allow bioptic driving; but that it is handled on a per-case basis. So, there are no specific rehab courses, facilities, etc. Everyone must apply with the Medical Testing Board through SGI (which is Saskatchewan Government Insurance) who is the issuer for all licenses and plates in the province. Once you have applied to the medical testing board cases are heard on an individual basis and if “instruction” is deemed necessary you are sent to a general rehabilitation centre to work with an OT until such a time as they see fit for you to test with whatever exceptional device you want to drive with. You then pay for a road test ($150) with the member of the medical testing board as the tester and if you pass you get a letter on your license indicating you are driving with a specialized device, and you can continue on your way to drive with the bioptic (or whatever other device. There are of course some caveats, base acuities, exceptions, etc. but that is in a nutshell how someone is allowed to drive with a bioptic in this province.
Susan Lendvoy, OT, CDRS, srlendvoy@sasktel.net and Susanne Adamson, OT, CDRS, Susanne.adamson@saskhealthauthority.ca are two (2) OT’s with knowledge and experience working with bioptic applicants for driving in Saskatchewan. Amber Boyd has become involved with pre-driver readiness training activities.
There is a growing interest being shown by OT’s across Canada re bioptic driving. On April 20th, 2023, Mr Chuck Huss conducted a 2.0 hr. virtual staff in-service on the basics of bioptics and driving to approximately twenty (20) OT’s from the Province of Ontario. Note, Canada has a number of CDRS’s (see www.aded.net); some of whom are somewhat knowledgeable re “bioptics” and “bioptic driving”. Use the following information to gain access to those professionals:
•Type in “www.aded.net” on Google
•Click on “Directory & Services”
•Click on “driver rehabilitation specialists”
•Insert “United States” , “West Virginia” and then click “continue”
•Scroll down and click on “Chuck Huss”, and then after Program Services, click “bioptic driving”
•Takes you to a list and contact information of bioptic driving service providers, who are members of ADED (180/30 states and 3 Provinces, as of 2025)
******* Quebec has had bioptic driving in place since the early 2000’s. Saskatchewan has only a handful of legally licensed bioptic drivers at this time.
Ontario is in the process of developing vision standards and standards for training and testing at the present time (following a favorable outcome of a legal case in Ontario, 2020-2021). The latter may impact other Provinces across Canada re whether bioptics will now be allowed.
New Brunswick had there first trial candidate this past year; but did not result in driver licensure (light sensitivity & contrast sensitivity issues with heavy snow conditions), as of yet. This was an issue that could not be resolved for this client for their eye condition but other clients may be more successful.
Updated new vision standards for bioptic driving in Ontario are as follows:
•16 years of age
•Best corrected visual acuity (BCVA) no less than 20/160 in the better eye
•Full visual field as required by regulations (i.e. 120°)*
•Contrast sensitivity values 1.35 or greater**
•Telescope power not to surpass 4X magnification
•Telescopes that are Autofocus in design are not permitted
•Enhanced visual acuity through telescope of 20/50 or better
•Telescope to fit in true bioptic position
•In office training including: focusing, spotting, and tracking
•Minimum three (3) months using bioptic device (on-foot, bicycle, passenger-in-car (PIC))
*Discretion applied re central scotoma
** Those applicants below 1.35 may be considered.
See Papers section of this website for******* For behind-the-wheel (BTW) training for Ontario, refer to 2024 PPT.
A few contact persons are as follows:
Quebec (has two (2) programs (Montreal and Quebec City)
Virgina Marchand, COMS
virginie.marchand.ciussscn@ssss.gouv.qc.ca
John Paul La Chance et al, Quebec, CAN
(John-Paul.LaChance@irdpq.qc.ca (He may be retired at this time)
Vincent Moore, OD, FAAO
vincent.moore.inlb@ssss.gouv.qc
Roger Dufour, OD, MSc
Joseph Paul Nemargut, COMS, PhD
Institut Nazareth et Louis Braille Longueuil, Québec, Canada
Others (see attached PPT. Presentation)
Ontario
Tammy Labreche BSc, OD, FAAO (initial OD who became involved in bioptic driving program rsearch, develpment, and implemerntation in Ontario)
Associate Clinical Professor
Director Centre for Sight Enhancement
Head, Sight Enhancement Clinics
Waterloo Optometry & Vision Science
200 Columbia St. West
Waterloo, ON
N2L 3G1
519-888-4567x37742
Stan Woo, OD
Zay Khan, OD
Melinda Szilva, SW
Tamalea Stone OT Reg. (Ont.), CDR
Senior Occupational Therapist / Ergotherapeute
Certified in Driver Rehabilitation / Specialist en readaptation de la conduite d’automobile
Driving Rehabilitation Service/ Service de réadaptation à la conduite automobile
The Ottawa Hospital Rehabilitation Centre/Centre de réadaptation de l’Hôpital d’Ottawa
Room 2503, Mailbox 951
505 Smyth Rd., Ottawa, ON K1H 8M2
T: 613-737-8899 ext 75502 | F: 613-737-6115
tstone@toh.ca or tstone.ot@hotmail.com
Hours of work : 8 :00 am to 4 :00 pm EST M-F
Wendy Nieuland, OT, CDR, LDI
Skill Builders Physiotherapy & Rehab Centre
370 Bayview Drive, Suite 100
BASrrie, Ontario L4N 7L3 Canada
TEL : (705) 727-0319 Ext. 114
FAX : (705) 727-0236
E-MAIL : wendy@skill buuildersrehab.com
Dr. Ana Juricic, OD (second OD doing evaluation, fitting and prescribing bioptic lesn systems in Ontario)
3101 Bloor St. West
Suite 102
Toronto, ON
M8X 2W2
TEL: 9647) 824-8733
E-MAIL: info@DrlowVision.com
New Brunswick
Maura DuLong, OTreg (NB) - served as an in-car back seat evaluator for first bioptic driving candidate undertaken in NB
Occupational Therapist/Ergothérapeute
Driving Rehabilitation Services/Services de réadaptation à la conduite
Stan Cassidy Centre for Rehabilitation/Centre de réadaptation Stan Cassidy
Horizon Health Network / Réseau de santé Horizon
(506) 447-4214
******* Graeme Leslie, Certified Driving Instructor (CDI) (worked in-car with first NB bioptic driving candidate that underwent driver’s training)
E-MAIL: ttooyyman2@hotmail.com
Jane Moore, Manager, Vision Rehabilitation
Vision Loss Rehabilitation
New Brunswick
Suite 3, 276 Rue Marie
Beresford, New Brunswick
E8K 1P8
Direct line: 506-546-6295, EXT: 9314
E-MAIL: Jane.Moore@vlrehab.ca
Julie Sirois, CLVT, works under Jane Moore (handled the pre-driver readiness needs of first NB bioptic driving candidate)
Saskatchewan
Susanne Adamson, OT, CDRS
Saskatchewan Health Authority -Regina area
2180- 23rd Avenue
Regina, Saskatchewan S4S 0A5
E-MAIL: sus@Sasktel.net
Suzanne Lendvoy
Saskatchewan Health Authority -Regina area
2180- 23rd Avenue
Regina, Saskatchewan S4S 0A5
E-MAIL: srlendvoy@sasktel.net
Dr. John Skorski, OD
FY idoctors (Visique)
308-3907 8 Street E
Saskatoon (Saskatchewan)
S7H 5M7
Telephone: 1-306-931-3937
Please email BDA to request advice about your specific question.
The clinical and functional vision assessment for low vision bioptic driving is consistent with recommendations from the International Council of Ophthalmology in their 2006 report 'VISION REQUIREMENTS FOR DRIVING SAFETY'.
Bioptic driving programs often recommend:
Visual acuity better than 6/60 through carrier lens
Visual acuity through the scope 6/12 or better
No more than 3 scotomas in the visual field
Harizonal 120 visual periphery
Can differentiate colour (can still be colour blind or deficient)
Contrast sensitivity age matched
Able to demonstrate glare recovery
A stable eye condition (no major variations)
If progressive, is regularly monitored
An optometrist can work with an orientation and mobility (O&M) specialist. After the above assessment the O&M can conduct static and dynamic in room and outdoor on foot and passenger in car assessments. These assessments contribute to understanding the candidates visual processing.
The primary target is Australians with central vision loss. This covers many types of eyesight conditions such as (click on the word at each dot point to view a video on bioptic driving for that eye sight condition):
Read more stories on this website.
A bioptic telescope can also be used in the workplace and for everyday activities like catching a bus, reading menu boards, in lecture theatres or tutorial rooms for the white board.
An example of words in the Assessing Fitness to Drive Guidelines:
Suggested Evaluation Protocol
1. A person applying for a driver's license shall be required to take a screening vision test administered by the licensing authority.
2. Any person whose binocular (with both eyes opened) visual acuity is worse than 6/12 Snellen corrected, should be referred to an Optometry or Ophthalmologist.
3. Further evaluation is likewise required when a visual field problem is suspected, as a result of a screening test failure, an accident report or the presence of any disease/exposure associated with visual field defects.
4. The optometrist or ophthalmologist shall determine the best correction for vision to improve to 6/12 Snellen or better.
5. An applicant whose binocular vision cannot be corrected to at least 6/12 Snellen shall need to undergo further testing to include but not limited to the visual fields, contrast sensitivity, glare sensitivity, depth perception and diplopia, using current practice standards.
6. Where bioptic telescopic glasses are used, the applicant must be able to achieve 6/12 Snellen or better through the scope and better than 6/60 Snellen through the carrier lens.
7. Adequate evaluation of all the aforesaid visual functions can assist the optometrist or ophthalmologist in forming their recommendation to the Driver Licence Authority, on the possible license restrictions and re-assessment interval deemed fit and fair for the applicant.
8. These recommendations which are based on visual performance alone, should be correlated by the Driver Licence Authority to the other medical problems, past driving performance and if necessary, on-the-road performance. The final responsibility for the issuance of driver’s license lies with the Driver Licence Authority.
*Whilst this information is USA based, the same theory applies to Australia in the absence of a current formal program on bioptic driving. Further, the source of this information is from the NAOH website so the references are directly tagarted to that audience. The information is still of relevance to all potential and current Australian bioptic drivers and candidates.
Driving skills
Some USA states’ licensing agencies use the same performance standards to evaluate the low vision driver as it uses to assess driving skills in the general population. These will generally include vehicle speed control, shifting and braking, depth and spatial perception, steering, use of mirrors, backing up and parking, knowledge of rules of the road, and courtesy.
A growing number of states are requiring special and oftentimes more in depth and longer, on-road testing of low vision candidates who want to secure or retain restrictive or non-restrictive driving privileges.
Drivers with albinism must also learn to effectively compensate for their low vision and may benefit from the following tips:
Use non-visual cues.
Look far ahead while driving (the faster you drive, the further out you must direct your central line of sight).
Keep eyes moving and be alert.
Check mirrors frequently.
See the whole picture and anticipate what the other driver will do.
Be sure you are seen and communicate your intentions.
Follow at safe distances, three or four seconds behind the proceeding vehicle at the current speed.
Watch for a last resort escape route.
Choose less demanding routes and know where to go in advance.
Communicate your intentions (using turn signals) and check traffic over your shoulder before changing lanes.
Look backwards before backing up.
Use other aids as necessary (hats, visors, tinted lenses, magnifiers, etc.).
New drivers, whether or not they have albinism and lower visual acuity, often experience typical problems. One common example is the difficulty almost all new drivers encounter when trying to steer the vehicle straight at high speeds the first time they drive on a highway. Because the new driver tends to look directly in front of the vehicle instead of focusing on a point in the distance (referred to as forward scan or eye lead time), he/she may tend to oversteer, and their vehicle may subsequently meander or move back and forth or in and out of the traffic lane. Patience and practice will allow the new driver to overcome these tendencies.
Drivers with albinism may experience some unique challenges in driving that other drivers with low vision do not encounter. For example, persons with albinism have very low tolerance to bright light and glare, and they do not have true binocular vision. They must learn to compensate for glare from the sun or oncoming headlights, and also must develop the ability to judge depth of field using monocular cues during various driving situations. Learning to ride a bicycle safely may help develop depth perception, compensation for various light conditions, judgment, reaction time, and familiarity with driving patterns.
Bioptic Driving
The most popular low vision aid utilized for driving by persons with albinism is the bioptic telescope. The bioptic consists of either a miniature Galilean or Keplarian telescope(s) positioned in the upper portion of or on top of a carrier lens. The carrier lens, which incorporates the individual’s standard refractive correction, is conventionally mounted in the frame. This arrangement allows the user to look through the carrier lenses for general driving purposes (approximately 90 per cent of the total driving time); and quickly (1-1.5 second per fixation) and intermittently through the telescopic unit(s) for spotting purposes only, the other 5-10 % of the total driving time. The latter allows the user to detect distant detail, color or activity as the dynamics of driving situation dictates. The most commonly used telescopic magnifications prescribed for driving are the 2.2X, the 3.0X and the 4.0X. The bioptic telescope is a lens system that requires time and training for an individual to become proficient in its use. The following is an effective bioptic training sequence that has been used by many individuals.
Rapidly locate stationary objects while you are still.
Rapidly locate moving objects while you are still.
Rapidly locate stationary or moving objects while you are moving (preferably as a passenger in a car).
Develop accurate visual perception skills to evaluate the environment rapidly.
https://www.albinism.org/information-bulletin-albinism-and-driving/
The ring scotoma effect should not be considered any greater issue than other normal driving activities such as using mirrors.
The original phrasing in the 2012 Guidelines that ‘their use may reduce visual perception in the periphery’ lacks scientific evidence. The modified words that were retracted from the 2016 Guidelines, ‘at the cost of visual field’ also lack any scientific evidence.
Spotting through the bioptic telescope is undertaken momentarily during driving to detect signs and traffic signal colours and is not used constantly while driving. ( Doherty et al 2011; 2013; 2015). Therefore the ring scotoma effect only occurs at the short moments of use of the bioptic, similar to looking into the rear vision mirror.
Keeney (1974) and Fonda (1983) suggested that the ring scotoma induced by a bioptic telescope is likely to restrict awareness of hazards when the telescope is momentarily aligned. (Keeney AH. Editorial: Field loss vs central magnification. Telescopes and the driving risk. Archives of ophthalmology 1974; 92: 273. Fonda G. Bioptic telescopic spectacle is a hazard for operating a motor vehicle. Arch Ophthalmol 1983; 101: 1907-1908.)
Public information also confirms the ring scotoma effect should not be considered any greater issue than other normal driving activities such as using mirrors.
“When looking through a bioptic telescope the enlarged image obscures some of the normal field of view. This area of lost vision is called the “Ring Scotoma.” Because some visual information is missing while sighting through the bioptic telescope, there has been concern that the driver might not see a potential obstacle. This would certainly be an issue if the individual were to be looking through the bioptic all of the time, but as we have already discussed, this is not the case. In fact, drivers miss visual information much more frequently and to a greater extent when they adjust the radio, the heater or air conditioner, or use their side or rear-view mirrors. As a result, the ring scotoma concern should not be considered any greater an issue than other normal driving activities.”
Extracted from: https://www.ocutech.com/consumers/driving-with-bioptics/
In lieu of the bioptic device being modified, what is really needed by those individuals/professionals in Victoria, who are opposed to the use of Rx bioptic telescopic lens systems (BTLS) for visual assistance in the driving task, is to understand for example that:
There is actually measurable, physical space between the bioptic user's eyeball and the surface of the carrier/support lens and the ocular lens end of the miniature telescope(s). This space allows the user to use their less distinct peri-central and peripheral vision to orient their position to space, stay in lane on the roadway, detect and react accordingly to objects or forms that threaten their line of travel with adjustments in speed and/or lane position, etc. This space is referred to as "vertex distance".
Vertex distance is clinically defined as the linear distance between the center of one's cornea (clear window surface of the eye) to the center of the carrier/support lens (during carrier lens viewing, which amounts to 90-98% per cent of the time during the driving task) or center of one's cornea to the center of the ocular lens end of the miniature telescope(s) during telescopic viewing, which amounts to the remaining 2-10% of time that the BTLS user is driving. Time spent viewing through the telescopic lens unit is kept short, intermittent, only 1-2 seconds per fixation. A fixation is the extent of time it takes to move from carrier lens viewing to telescopic lens viewing and back to carrier lens.
Telescopic viewing/short-term vertical spotting should only be undertaken when the low vision driver is driving on straight or relatively straight stretches of roadway, presenting ample sight distance (and then only in the absence of other road users in one's surrounding space cushion around their vehicle).
The BTLS user should never dip down into the miniature telescope(s) when sight distance ahead is restricted: for example on a curvy roadway surface (especially blind curve), nearing the top of a hilly road surface, approaching a dip in the road (especially where other road users in the same or opposite direction disappear), etc.
You can demonstrate the existence of this space for peripheral viewing ability by having the BTLS user purposely view continuously through their telescope at the back end of a parked vehicle in an empty parking lot from say the distance of 30-40 yards and have another person travel on foot from the BTLS user's far periphery (180 degrees to the right or left) in an arc across the front 180 field of view of the BTLS user). The only time the object or form (a moving person) disappears is when the moving form is temporarily in the blind spot created by the ring scotoma, created by looking through the telescope. if the BTLs user has only one miniature telescope, some systems allow the non-telescopic eye to override the ring scotoma of the telescopic viewing eye.
Source: Related knowledge accrued by Chuck Huss, COMS, 1976-2026 by direct observation of VI clients undergoing clinical low vision examination procedures as part of my O&M internship, conducted at the Michigan Rehabilitation Center for the Blind & VI, Kalamazoo, MI (Winter, 1976), and attending four (4) decades of low vision conferences, workshops, seminars, and a few professional optometric meetings (i.e. the 1984 PA Optometric Meeting, Harrisburg, PA (where "Vision and Driving Issues" were discussed and debated, before the start-up date of our WV Pilot Low Vision Driving Study (July 1, 1985)
If those who oppose the use of Rx bioptic telescopic lens systems (BTLS) for driving are saying such systems are unsafe for driving because the telescopic portion of these types of lens systems do not meet the set visual field parameters/requirements in the Assessing Fitness To Drive Guidelines, they would be correct if the telescopic portion of such devices were used the greater majority of the time during the driving task. But in reality, viewing through the telescopic portion of one's BTLS is only undertaken 2-10 % of the total driving time, and then only intermittently as needed/called for (to help discern detail, colour, or action taking place further down the roadway) for brief glances at a time amounting to 1-2 seconds per fixation, on straight or relatively straight stretches of roadway only, with ample sight distance ahead, and such "vertical spotting procedures" are only incorporated into the driving task when the user does not have other road users in the driving space surrounding their vehicle.
In order to safely operate a motor vehicle, drivers must be able to identify cues within their full visual field (i.e., using carrier lens viewing, which amounts to 90-98 percent of the time spent while driving), accurately assess this information, and take appropriate action. Many persons with mild to moderate levels of visual acuity (VA) loss are capable of detecting or recognizing these cues; however, due to reduced central VA, identifying or interpreting them may be a challenge. With the aid of the attached miniature telescope and specialized driver training, many of these individuals can learn to drive safely, said driver rehabilitation specialist, Charles P. Huss, COMS.
Source: Taken in part from Low Vision Drivers: The Ophthalmologist's Role and Responsibility, EYENET Magazine, 2017, pp. 33-35, by Leslie Burling-Phillips, interviewing Rhonda Dalyai, MA, TVI, CDI, Charles P. Huss, COMS, Cynthia Owsley, PhD, MSPH, and John D. Shepherd, MD.
The first step should be to go see an expert in the use of bioptic devices to be assessed if you are a suitable candidate for bioptic driving.
Some factors that assist a potential bioptic driver include that they use or have a history of use of a telescope device. This creates familarity with the use of a bioptic device, the user just needs to learn a new technique for driving. Many persons with vision impairment went to school using a monocular or mini scope device to read classroom boards. Another factor is if the person participates in activities that are fast moving as this links to use of sight and cognition to movement. This may include running sports, cycling or ball sports. For those with prior driving experience, a good driving history is also helpful.
Driving is a complex task. Regardless if you are assessed as a potential candidate for bioptic driving, if you do not feel that personlly diriving is for you or that you are not able to personally maintain safe driving practices, then you should not drive. This applies to all persons, not just persons with a vision impairment.
It is also important to recognise beginning a new task and learning new skills will always be daunting. Research has shown specific bioptic driver training can provide drivers with skills to give them confidence to overcome some barriers to fear. It is always helpful to practice the skills given by the bioptic driving specialists. In addition, seeking advice from other bioptic drivers and looking at blogs and success stories can help with understnding how others have travelled down that journey and spark ideas that may help you overcome barriers.
One commonly used strategy by potential bioptic drivers and recommended as standard practice for learner dirvers is commentary driving. Whilst the technique is used by learners as they drive, for bioptic drivers, this technique is also used for a duration of time before they decide to begin to learn to drive and whilst sitting in the passenger seat practicing to use the bioptic device as though they are driving the car. Feedback from the driver or another passenger assists this learning.
All bioptic drivers go through the regular training process in each Australian state or territory to obtain licensure. In addition, the bioptic driver must learn skills for use of the bioptic. This means they generally will seek more formallised learning from a professional including, their driving instructor.
Some of the strategies reported include:
Eye bouncing. This technique is done through the carrier lens where you actively bounce your gaze from the distance to what is directly infront of you. The active gazing helps to keep the driver aware of their surroundings in front of them and in the distance.
Maintain at least the minimun three meter gap or a little more if travelling at high speeds of 100km/hr. Some drivers have reported that this technique helps them manage in case of an emergency situation, even though unlikely to occur. They maintain the gap even when cars cut in by backing off to ensure that gap is still present.
Always keeping their windscreen clean. Some drivers report clearning theri windscreen daily or close to this. It is important all controllable factors are managed, clean winders allows clear sight, especially through the scope. Driver have also reported dirty windows will make it harder to see through the windscreen at times of low light in sunset and sunrise.
Doing a course in defensive driving. These courses extend beyond the learner training and include techniques for car handing for emergency braking, understanding your blind spots in your eyes and on the car and other tips to increase your awareness on how to improve safe driving practices.
Drive as often as possible and when you obtain your provisional licence, drive every day if you can.
Drive only in familar areas. This may mean you travel as a passenger first to learn the route, the street signs and marking and warning signals. As you become familar with driving in known areas you can expand your known areas overtime.
Understand your restrictions and always abide by them. For example, if you are glare senstive, drive at other times than sunrise or sunset (some bioptic drivers make a reasonable adjustment agreement with their employer to work alternative hours so they do not drive at these times). Or, take a different route that will not mean you are driving into the sunrise or sunset.
Use a dash cam. Some drivers use a dash cam (sometimes a dual channel one that points outside the windscreen with the second camera either pointing at the driver or the back window) to record on a continuous loop their driving activity. Such a tool reminds the driver that they are being watched so helps to keep them honest with their behaviour. It is also useful should an incident occur to put forward video evidence.
Join the BiOptic Driving Network [unofficial] Facebook group or contact other bioptic drivers and ask questions.
Do a basic car maintence course to learn to change a wheel, first aid, jump start car, etc. Image the positive impression you will give as a bioptic driver pulling over to help someone change their tyre or jump start their car.
Formalised bioptic driving programs that BDA advocated for Australians provide opportunity for wrap around support regardless if you are told you are a candidate or you can no longer drive. BDA understands because we have the lived experience and we know what is it like to be told you cannot drive and to live a life without a drivers licence. We also know how unhelpful it is for medical people to tell you about the consequences of you having an accident - making it all your problem when really it is a system problem.
BDA want to see Australians have access to independent transport that is why are proposed framework focuses on mobility, not just driving. Driving is only option of being mobile and a true mobility program encompases all options available to that person. These are considered through a progrm from the low vision optometrist to the orientation and mobility specialistic and if available to you, the driving instructor. Much of the learnings form the Churchill travel blogs have been encompassed for an Australian centric program to be person centred.
As an example, an orientation and mobility specialists works with people where they are at currently in terms of their funcitonal vision and mobility and discusses options for travel. These can include walking, riding a bike, catching publc transport, rideshare, community transport and family and friends. The O&M helps people to isolate their available senses including visual scanning and the use of assistive technology such as the bioptic or the much cheaper monocular. They teach navigation skills using the mobile phone. They also provide travel skills for the long white cane and conjuction with other mobility aides like a walking cane, walker, wheelchair.
BDA wants this perceived gap filled through establshed mobility programs throughout Australia where all people with vision conditiosn receive wrap around support from assessment to options to mobility to independence - regardless how that looks.
Critics of using bioptics for driving raise several concerns including:
Small visual field through the bioptic telescope;
Ring scotoma causing a hazardous blind spot;
Vibration and speed blur;
Telescopic parallax (shifting of view) and depth perception;
Critical adjustment of the bioptic frame and angle of the lens.
Proponents of the use of the bioptic telescope respond:
The visual field through various types of bioptics of 6 to 17 degrees is actually larger than the 5 degree foveal (precise vision) area for a normally sighted person with 20/20 vision.
The ring or rectangular shaped scotoma (blind area) around the telescope does not pose a hazard when the bioptic user moves their head and is moving through space in a vehicle because no object can be “lost” for a significant length of time in the scotoma under these conditions.
Everyone, no matter what vision they have, experiences deterioration of the visual image due to speed blur at increased speeds and this phenomena is unrelated to the use of the bioptic.
It is unnecessary to have binocular vision in order to perceive depth. Drivers who have vision in only one eye (but do not have low vision) perceive depth monocularly and drive safely.
A bioptic focused for distance will be able to magnify the reflected image for the user as if the user were looking at the object in the distance.
Adjustments of the lens and frame are critical. Most prescription bioptic lens systems present adjustable nose pads and spring loaded hinges for a snug fit. Follow-up with the dispensing clinician assures that the latter system is positioned correctly.
https://www.albinism.org/information-bulletin-albinism-and-driving/