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One of the hardest questions eye care professionals deal with every day is when to tell people who are having difficulty with their vision to stop driving.

Giving up your driving privilege is one of the most difficult realities to come to terms with if you have a problem that leads to permanent visual decline.

The legal requirements vary from state to state. For example, in New Jersey the legal requirement to drive, based on vision, is 20/50 vision or better with best correction in one eye for a “pleasure” driving license. For a commercial driving license, the requirement is 20/40 vision or better in both eyes.

In some states there is also a requirement for a certain degree of visual field (the ability to see off to the sides).

According to the Insurance Institute for Highway Safety, the highest rate of motor vehicle deaths per mile driven is in the age group of 75 and older (yes, even higher than teenagers). Much of this increased rate could be attributable to declining vision. There are also other contributing factors such as slower reaction times and increased fragility but the fact remains that the rate is higher, so when vision problems begin to occur with aging it is extremely important to do what is necessary to try to keep your vision as good as possible.

That means regular eye exams, keeping your glasses prescription up to date, dealing with cataracts when appropriate and staying on top of other vision-threatening conditions such as macular degeneration, glaucoma and diabetes.

It is our responsibility to inform you when you are no longer passing the legal requirement to drive. Although there is no mandatory reporting law in all states, it is recorded in your medical record that you were informed that your vision did not pass the state requirements to maintain your privilege. And, yes, it is a privilege - not a right - to drive.

If you have a significant visual problem and your vision is beginning to decline, you need to have a frank discussion with your eye doctor about your driving capability. If you are beginning to get close to failing the requirement you need to start preparing with family and love ones about how you are going to deal with not being able to drive, preferably before it becomes absolutely necessary.

We have had the very unfortunate occurrence of having instructed a patient that he should stop driving because his vision no longer met the requirements only to have him ignore that advice and get in an accident. Don’t be that guy. Be prepared, have a plan.

Article contributed by Dr. Brian Wnorowski, M.D.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ. This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician.

The word “astigmatism” is used so much in the ophthalmic world that most people have talked about it when discussing their eye health with their doctor.

“Astigmatism” comes from the Greek “a” - meaning “without” - and “stigma” - meaning “a point.” In technical ocular terms, astigmatism means that instead of there being one point of focus in the eye, there are two. In other words, light merges not on to a singular point, but on two different points.

This is experienced in the real world by blurred, hazy vision, and can sometimes lead to eye strain or headaches if not corrected with either glasses or contact lenses.

Astigmatism is not a disease. In fact, more than 90% of people have some degree of astigmatism.

Astigmatism occurs when the cornea, the clear front surface of the eye like a watch crystal, is not perfectly round. The real-world example we often use to explain astigmatism is the difference between a basketball and a football.

If you cut a basketball in half you get a nice round half of a sphere. That is the shape of a cornea without astigmatism.

If you cut a football in half lengthwise you are left with a curved surface that is not perfectly round. It has a steeper curvature on one side and a flatter curve on the other side. This is an exaggerated example of what a cornea with astigmatism looks like.

The degree of astigmatism and the angle at which it occurs is very different from one person to the next. Therefore, two eyeglass prescriptions are rarely the same because there are an infinite number of shapes the eye can take.

Most astigmatism is “regular astigmatism,” where the two different curvatures to the eye lie 90 degrees apart from one another. Some eye diseases or surgeries of the eye can induce “irregular astigmatism,” where the curvatures are in several different places on the eye’s surface, and often the curvatures are vastly different, leading to a high amount of astigmatism.

Regular astigmatism is treated with glasses, contact lenses, or refractive surgery (PRK or Lasik). Irregular astigmatism, such as that caused by the eye disease keratoconus, usually cannot be treated with these conventional methods. In these circumstances, special contact lenses are needed to treat the condition.

The next time you hear that either you or a loved one has astigmatism, fear not.

It is easily corrected, and although astigmatism can cause your vision to be blurry it rarely causes any permanent damage to the health of your eyes.

If you experience blurred vision, headaches or eye strain, having a complete eye exam may lead to a diagnosis and treatment of this easily-dealt-with condition.

Article contributed by Dr. Jonathan Gerard

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.