For many Australians, driving represents far more than getting from A to B. It is independence, spontaneity, and connection: the freedom to get to work, see friends, attend appointments or simply leave home without relying on someone else.
When changes in vision affect driving, the impact can extend well beyond the driver’s seat. Essential appointments may still happen because people call in favours or organise a lift. It is often the less visible parts of life – social outings, interests, and everyday choices – that quietly fall away.
Members of SeeWay’s Client Advisory Panel who live with low vision describe relying heavily on partners and family, particularly where public transport is limited or difficult to access. One said, “I rely solely on my husband. What if I was alone?”
Cost creates another barrier. “I can’t afford $50 any time I want to get somewhere,” one panel member said. Another, who could still drive locally but could not walk to the bus stop, questioned what might happen if they could no longer drive at all. The cumulative effect was captured in one stark reflection: “I’m getting more housebound, and I’ve never been a person who likes to stay home.”
For eye care professionals, these experiences show why a conversation about driving should explore more than whether a person still holds a licence.
Assessing Fitness to Drive
Occupational therapist and specialist medical driver assessor Basia Kmita works with people whose driving has been affected by macular degeneration, cataracts, diabetic eye disease, stroke, brain injury, and other conditions. She hears about blurred or double vision, sensitivity to glare, difficulty reading street signs and house numbers, problems judging distance, and reduced awareness of vehicles in the periphery. Rain, changing light, and night driving can make these difficulties more pronounced.
Ms Kmita’s role is to assess an individual’s circumstances, providing a comprehensive off- and on-road medical driving assessment. The off-road component involves functional vision and cognitive screening. During the on-road component, observation, speed control, planning and judgement, reaction times, and vehicle positioning are assessed. Feedback may also be provided about vehicle ergonomics.
Often, people have already begun adapting before a formal conversation takes place. They may avoid tunnels and multilane roads, take back streets, stop driving at night, or restrict themselves to familiar local trips. These changes do not, by themselves, determine whether someone is safe to drive. They do, however, offer a valuable opening to understand how the person is managing and what may already be narrowing in their life.
Raising the subject early is not the same as telling someone to stop driving. It gives the patient time to ask questions and prepare for possible changes without making decisions in a moment of crisis.
Asking the Right Questions
Rather than asking, “Are you still driving?”, eye care professionals might ask: “Has the way you drive changed?”, “Are there places or times you now avoid?”, and “What would become harder if you could no longer drive?” These questions can uncover not only functional changes, but also the broader consequences for a person’s independence, relationships, and participation in everyday life.
The goal is not driving at all costs. Nor is it simply removing the keys once a clinical threshold is crossed. It is helping each person preserve safety, independence, and connection – whether they continue driving, adapt how they drive, or transition away from it.
Raising the subject early is not the same as telling someone to stop driving. It gives the patient time to ask questions and prepare for possible changes without making decisions in a moment of crisis. Where vision changes are progressive, transport alternatives can be introduced gradually rather than during an already emotional transition.
If a person no longer meets the required vision standards, the news can be confronting. Some people may resist it; for others, it confirms what they already suspected. Ms Kmita recommends allowing time for the news to be processed and, where appropriate, involving a trusted support person. She also suggests checking in again after the initial conversation, when the person may be better able to consider what comes next.
The way the conversation is framed can make a difference. Ms Kmita suggests acknowledging the person’s driving history rather than focusing only on what is being lost. For someone who has driven safely for decades, stepping away before a serious incident can be framed as protecting that record – not diminishing their capability or identity.
Confirming whether a patient meets the relevant vision standards may resolve the clinical question, but it does not resolve how they will continue working, caring for others, maintaining relationships, or participating in their community.
Support after driving changes must extend beyond a list of transport options.
Patient Support
Support after driving changes must extend beyond a list of transport options. Public transport may be scarce, inaccessible, or impractical, particularly in regional areas. Taxis and rideshare services can be unaffordable, while relying on family can leave people feeling dependent. Knowing how someone will reach a medical appointment is important; understanding how they will keep seeing friends, pursuing interests, and making spontaneous choices is equally so.
The practical and emotional consequences may only emerge after the patient has left the consulting room. Clinical care can provide an important bridge to support beyond the diagnosis. Asking early about driving, transport, and social connection creates an opportunity to connect a patient with support before their world becomes smaller.
Contacting SeeWay
SeeWay complements clinical care by supporting the whole person as they adjust to permanent changes in vision. The free national service offers trusted information, digital skills training, and no-gap counselling for people with vision changes and their loved ones. This may include help using accessibility features, transport apps, or online services, alongside emotional support through a significant change in independence.
No formal referral is required. Eye care professionals can encourage patients and their loved ones or carers to visit seeway.com.au or call 1800 SEE WAY (1800 733 929). SeeWay is now also available on Oculo.
Michael Angerame BVisSci MOptom is the Business Development Manager at SeeWay.
