Physical Qualification Standards and Advisory Criteria - Vision

Question 1

What regulation states the physical qualifications for drivers?

Answer 1

49 CFR 391.41

Question 2

What are the standards for vision?

Answer 2

Distant visual acuity of at least 20/40 in each eye w/o corrective lenses OR visual acuity separately correct to 20/40 or better with corrective lenses

Distant binocular acuity of at least 20/40 in both eyes w or w/o corrective lenses

Field of vision of at least 70deg in the horizontal meridian in each eye

The ability to recognize the colors of traffic signals and devices showing standard red, green, and amber

Question 3

When corrective lenses are used to meet vision qualification requirements…

Answer 3

The corrective lenses must be used while driving.

Question 4

Who can perform and certify vision test results?

Answer 4

A medical examiner, ophthalmologist, or optometrist

BUT, the medical examiner determines driver certification status

Question 5

Is monocular vision allowed?

Answer 5

No, monocular vision is disqualifying.

Question 6

What should you look for on physical exam of the eyes?

Answer 6

Pupillary equality
Reaction to light and accommodation
Ocular motility
Ocular muscle imbalance
Extraocular movements
Nystagmus
Exophthalmos

Question 7

What are the required tests for vision?

Answer 7

Central visual acuity (Snellen)
Peripheral vision
Color vision

Question 8

The Snellen wall chart should be ___ feet away from the driver.

Answer 8

20 feet

Question 9

What is the denominator in teh snellen test result?

Answer 9

The number of the last line of type the driver can read accurately

Question 10

If a test other than the snellen is used for central vision acuity, you must…

Answer 10

Record the test results in Snellen-equivalent values

Question 11

What is the requirement for peripheral vision?

Answer 11

at least 70deg in the horizontal meridian in each eye

Question 12

When peripheral vision test results are inconclusive, you should…

Answer 12

Have the evaluation performed by a specialist with equipment capable of precise measurements

Question 13

What is the color vision requirement?

Answer 13

The ability to recognize and distinguish among red, amber, and green, the standard colors of traffic control signals and devices.

Question 14

What is considered monocular vision?

Answer 14

When the vision requirements are met in only one eye, with or without the aid of corrective lenses, regardless of cause or degree of vision loss in the other eye.

Question 15

Why is monocular vision disqualifying?

Answer 15

In low illumination or glare, it can cause deficiencies in contrast recognition and depth perception compared to binocular vision.

Monocular vision is disqualifying

Question 16

The driver with monocular vision who is otherwise qualified may…

Answer 16

Apply for a Federal Vision Exemption

Question 17

How should a driver with an already valid federal vision exemption be examined?

Answer 17

At ANNUAL recertification, driver should present a valid vision exemption and a copy of the specialist eye examination report BEFORE receiving the medical examiner’s certificate.

Question 18

Qualified drivers with a valid federal vision exemption may be qualified for …

Answer 18

Up to one year

Question 19

When applying for a federal medical exemption, the driver should…

Answer 19

Include a copy of the medical examiner’s report form and the medical examiner’s certificate with the application.

Question 20

How should the medical examiner’s certificate be completed if driver is applying to the federal vision exemption program?

Answer 20

Certify the driver for up to 1 year, and mark the “accompanied by” exemption checkbox and write “vision” to identify the type of exemption.

Also provide the driver with a copy of the medical examination report.

Question 21

If a driver is using ophthalmic preparations to treat a condition, what must the medical examiner determine?

Answer 21

If the treatment is having the desired effect of preserving vision that meets the qualification requirements without any visual and/or systemic side effects that interfere with safe driving.

Question 22

Slow, progressive opacification of the crystalline lens of the eye that distorts the optical passage of light to the retina resulting in diminished visual acuity

Answer 22

Cataracts

Can be accelerated by conditions such as injury, exposure to radiation, gout, certain meds (steroids), and DM

Question 23

____ may be an early symptoms of cataracts

Answer 23

Glare, particularly during night driving in the face of oncoming headlights

Question 24

What is the treatment for cataracts?

Answer 24

Surgical removal and placement of an intraocular lens

Question 25

Glaucoma is caused by

Answer 25

Abnormal regulation of intraocular pressure, resulting in gradual progressive atrophy of optic nerve cells

Question 26

Can vision loss caused by glaucoma be restored?

Answer 26

No

Therapeutic goal is to lower intraocular pressure to a level that preserves existing neuronal cells and prevents further loss of the peripheral visual field deficit.

Question 27

Leading cause of untreatable legal blindness in the US

Answer 27

Macular Degeneration

Question 28

Vision loss from MD is typically…

Answer 28

Interference with detailed, central vision

Peripheral vision is generally spared

Question 29

The use of ____ lens are not acceptable for commercial driving

Answer 29

Telescopic lenses

Used for MD, they redirect unaffected peripheral vision to compensate for lost central acuity, resulting in reduced peripheral vision

Question 30

Noninflammatory damage to the retina of the eye, most commonly caused by DM.

Answer 30

Retinopathy

Common after 5-7 years with DM

Question 31

How to prevent retinopathy

Answer 31

Strict control of blood glucose and medical control of comorbid diseases (eg HTN, renal disease, cardiac disease)

Question 32

Medical guidelines for the driver with DM

Answer 32

Annual medical examination

Annual ophthalmologist or optometrist eye evaluation

Disqualification for a diagnosis of unstable proliferative retinopathy.

Question 33

______ retinopathy is characterized by rapid onset of blindness caused by retinal degeneration, usually of photoreceptors

Answer 33

Carcinoma-associated retinopathy

Question 34

______ retinopathy can be a complication of sickle cell disease and sickle cell-thalassemia disease

Answer 34

Proliferative retinopathy