BIOPTICS THE SOUTH AFRICAN WAY ALLAN KAYE RODNEY STEDALL Assisted by Hazel Sacher.

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Presentation transcript:

BIOPTICS THE SOUTH AFRICAN WAY ALLAN KAYE RODNEY STEDALL Assisted by Hazel Sacher

SOUTH AFRICA 2010

PROBLEMS PRESCRIBING BIOPTICS Driving decisions are based on vision Standard tests in current use are unreliable in predicting unsafe driving A driving license is a privilege and not a right A heavy onus is placed on the optometrist to make a decision on whether the client will be a safe driver Paucity of training facilities Cost / medical aid

THE BIOPTIC STUDY ABK RS BH Total prescribed Age range – Mean age Sex Males Females Total number of people in the study 81 Published data indicates a higher crash rate in the under 18 and over 75 Legal age to obtain a driving license in SA is 18

RANGE OF REFRACTIVE ERROR ABK RS BH Range – to to to 3.00 > Cyl -6.00x x X9

VISUAL ACUITY WITH BEST SPECTACLE CORRECTION Best Eye 20/ /50 Weaker Eye 20/200 - NLP

Pathologyof clients TOTAL ALBINISM 15 STARGARDTS 14 MACULAR 13 CONG CATARACTS 3 DIABETES 3 NYSTAGMUS 9 OPTIC ATROPHY 10 OTHER 13 Total 81 TOTAL

pathology

Primary uses of Bioptic ABK RS BH DRIVING OTHER WHY THE NEED FOR BIOPTICS The ability to drive contributes strongly to one’s quality of life To meet the criteria of legally obtaining a driving license

Technical details of Bioptics prescribed Magnification ABK RS BH 2.2 x x x Monocular Binocular Type of Bioptic Designs for Vision Occutech 3 - -

VISUAL ACUITY WITH BIOPTIC V A with Bioptic SA 20/ /50 V A with Bioptic USA 20/ /50 Bioptic population USA 20/50 – 20/200 Bioptic population SA 20/ /400 What is important is that quantitative measures should give way to qualitative measures

DRIVING STANDARDS SA USA Visual acuity 20/40 20/40 Visual field 140 total 140 total Visual acuity if 20/30 one eye blind Field with one 115 total eye blind Facts from the USA re driving with a Bioptic Unrestricted license / /70 With road evaluation / /200 Restricted license /100 e.g. time of day; area

Documentation required by authorities in granting a licence to Bioptic clients SA USA Uncorrected VA Y Y Corrected VA Y Y Peripheral fields Y Y Stability of pathology N Y Depth Perception N Y Color Vision N Y Ability to co-ordinate head N Y neck and eye movement Contrast sensitivity glare - N Y recovery luminance

THE BASIC GUIDELINES ADOPTED IN PRESCRIBING BIOPTICS A driving licence is a privelege and not an automatic right Visual acuity and Visual fields The will to drive Age; Health Must master the dynamic skills essential for driving with a bioptic eg cognitive sensory motor and scanning skills; good eye – hand co-ordination Binocular if possible Stability of pathology

THE WAY FORWARD UFOV computer testing for the LV client Reduce reliance on the present acuity for legal driving The clients visual & functional performance with the bioptic should be the main factor in granting a licence Standardised tests for cognitive motor and sensory functioning Driving instructors who are educated in the problems associated with disabilities 2 – 3 yr follow up

IS SOUTH AFRICA DIFFERENT ? Visual acuity with the bioptic is similar Legal driving standards re vision and fields are similar The onus for prescribing a bioptic for driving in SA rests on the optometrist The USA optometrist has more guidelines in reaching a decision Training in the use of a bioptic rests heavily on the optometrist