Publication Date: 
Wednesday, July 31, 2019

The Problem: In the United States, motor vehicle–related accidents are the leading cause of death for all persons in the U.S., with more than 100 people dying every day In 2013, motor vehicle crash deaths cost roughly $44 billion in lost productivity and medical bills. CDC: Motor vehicle safety. The number of licensed drivers over the age of 65 has increased dramatically over the last decade. In 2016, there were almost 42 million licensed drivers 65 years old or older, a 56% increase from 1999. In the same year, 7,400 adults 65 years old or older were killed in motor vehicle crashes, and more than 290,000 were injured. Drivers 80 years old and over have a higher rate of fatal crashes per miles driven than all other demographic groups except teenagers. The impact of aging on vision, cognitive functions, and other physical capacities has been identified as a contributing factor in motor vehicle crashes. CDC Website - Older Adult Drivers: Fact Sheet.  

The Law: State transportation and safety laws require different procedures and apply different standards in screening the vision of older drivers. For instance, to renew a license in California, an individual must have visual acuity of 20/40 with both eyes together and at least 20/40 in the stronger eye and 20/70 in the weaker eye, California Department of Motor VehiclesCA Vehicle Code §12805; in Arizona, a minimum of 20/40 in one eye is required. Arizona Administrative Code: R17-4-502, R17-4-503. The age at which vision tests are required for renewal also varies (e.g., 40 years in Maryland (Maryland Transportation Code 16-115(h)) to 80 years in Virginia. VA Code Ann. § 46.2-46.2-330 (C). For another example of a state law requiring vision screening for individuals above a specified age, see FL Rev. State 322.18(5) (Florida).

The Evidence: A Cochrane Collaboration Task Force attempted to conduct a systematic of studies assessing the impact of vision screenings for older drivers on motor vehicle crashes, but did not find any studies meeting its criteria. Desapriya E et al. Vision screening of older drivers for preventing road traffic injuries and fatalities. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.:CD006252. The task force accordingly concluded that there is insufficient evidence to determine whether vision screening programs for individuals above a specified age are effective in reducing crashes among older adults.

The Bottom Line: In the judgment of a Cochrane Collaborative expert panel, laws requiring vision screening are a plausible means of reducing crashes involving older drivers, but there is insufficient evidence to rigorously assess their effectiveness at this time. 

Additional Information: The Physician’s Guide to Assessing and Counseling Older Drivers, created by the American Medical Association (AMA) with support from the National Highway Traffic Safety Administration (NHTSA), is available online and provides substantial information about state policies regarding vision screening.

The International Council of Opthalmology provides online access to a table of vision requirements for the fifty US states.

Additional Resources: Physician’s Guide to Assessing and Counseling Older Drivers, AMA, NHTSAInternational Council of Opthamology

Impact: Uncertain