Employees may have their vision reclassified by obtaining necessary corrective glasses. By doing so, many become qualified for higher paying assignments. Eye examinations are repeated every 2 years to detect any change in vision thresholds. The skills of all departments are utilized in improving visual conditions in the plants. Engineers work closely with the safety department in determining adequate illumination for various work areas. This is especially important on precision work, which often calls for individual lights on machines in addition to overhead lighting. Light-meter studies are a continuing program throughout the plants. VISION AND PLANT LIGHTING Light fixtures and windows are cleaned frequently. Most plant walls and ceilings are painted nonglare white to reduce reflections. During the course of light studies, attention is paid to the elimination of distracting shadows. In close work, machines are positioned for maximum light values. This is important to quality work as even clear plano lens of good optical rating tend to reduce the amount of light reaching the eye. If the visual efficiency of the worker is near the minimum required for the job, a minimal loss of light perception might result in poor work performance. Conversely, adequate lighting can contribute importantly to upgrading work quality. In the event that an employee's visual acuity drops below the standards set for his job, he is usually reassigned to duties less demanding in vision requirements. However, this is done only when it is determined that the employee's poor vision cannot be corrected and he presents a hazard to himself and his fellow workers. There are jobs in automotive plants in which dexterity and the sense of touch are important qualifications. In fact, a totally blind worker was hired in our Kenosha plant to perform one of these assembly functions. The Kenosha safety director is assisted by four field safety men who spend a good part of their time looking for potentially hazardous situations on plant property. Particular attention is paid to projections or suspended tools and structures that might produce eye injuries. In the constantly changing panorama of an automotive plant, this is a never-ending project, but one which is important to a good plant safety rating. In case of injury, the worker is instructed to report immediately to his supervisor. The plant hospital provides first aid for minor injuries. If additional medical care is indicated, the employee may consult his own doctor or a member of American Motors' medical panel. The panel includes four eye specialists. In the main, successful safety engineering is dependent on the degree of cooperation by employees. If the worker is convinced that safety rules are established for his protection and best interests, he will usually observe regulations and follow safe work practices. This is why employee education is allimportant to the plant safety record. Safety engineering is the strategy in the war against industrial accidents; diligent and unrelenting programs of employee safety education are the tactics by which the battle is won. 1 VISION FOR DRIVING PRELIMINARY REPORT ON A SURVEY, WITH RECOMMENDATIONS FOR AN ACTION PROGRAM Good vision is an obvious requirement for safe driving, yet millions of drivers have uncorrected vision problems that make them highway hazards. Many are unaware of their handicaps until an accident occurs or they receive some type of eye test. Fortunately, all but a minute fraction of all licensed drivers could, with the aid of modern science, have vision that is up to par. There is probably no element of highway safety with a greater undeveloped potential for improvement. The remedies are known, available, and being applied, but not extensively enough. In many States only casual eye tests have been made by driver license examiners. Insufficient funds have been available for driver licensing in general, and facilities for anything but a superficial eye chart test have seldom been 1 Released by American Optometric Association, 4030 Chouteau Ave., St. Louis, Mo. provided. Often there has been unjustified fear that large numbers of drivers might be denied licenses if more comprehensive tests were given. There is lack of faith in moderation and lack of information on the possibilities of correction of below par vision. State laws on vision tests have been lax, and there has been little pressure of public opinion for progress beyond the first perfunctory eye tests of a generation ago. A study of 3,000 drivers For these and other reasons, there has never been adequate information on the extent of vision problems among drivers. In 1957 a voluntary vision-screening survey was launched by the American Optometric Association and its woman's auxiliary in cooperation with the Automotive Safety Foundation, the National Home Demonstration Council, and other organizations. Its basic purpose was to find what percentage of licensed drivers fall below acceptable standards on the major visual requirements for safe driving. Portable screening equipment was set up in scores of communities in 25 States. Drivers were invited to have their vision tested by standard techniques, without charge or obligation. The tests were administered by laymen, but supervised by licensed vision specialists. Almost all nontechnical details were handled by women's organizations-members of the woman's auxiliary of the American Optometric Association, National Home Demonstration Council, and the women's division of the Automotive Safety Foundation. Both men and women drivers were tested, and in about the same proportions as licenses are held by male and female drivers. Elements of safe vision While much technical terminology is used in describing vision problems and vision tests, anyone capable of driving can understand the visual requirements for safe driving. The results of the tests and the principles of correction of the common shortcomings are just as readily understood. The tests in the survey dealt with these essential visual "skills": Acuity-ability to focus and see clearly with each eye separately and both eyes together, particularly at a distance of many feet or yards. This is essential for seeing danger, reading road signs in time, and for general adaptation to the critical driving environment. It is essential but only a small part of the total visual requirement. The tests were under carefully controlled conditions for as much uniformity as possible. It is the only "skill" tested in the conventional Snellen letter-chart test used by most driver license examiners, and usually the tests are under such varying conditions of light, cleanliness of test charts, etc., that even this, the only usual test, is far from adequate. Depth perception-ability to judge space and distance. For most drivers this depends on good binocular (two-eyed) vision, because space and distance are determined by the brain in relating the image from one eye to the image from the other at the slightly different angle that results from the separation of the two eyes. Depth perception is essential for judging whether a car can be passed safely or whether a driver has time and space to maneuver from one lane to another among fast-moving vehicles on a highway. The screening instruments used in the survey tested both binocularity and space judgment-neither of which is covered adequately in the conventional eye test for driver licensing. Field of vision-ability to see to the sides when focused straight ahead. This, of course, is essential to detect crossroad traffic, pedestrians at the side of the road, and for ease in watching interior and exterior rear-view mirrors and for an adequate grasp of the visual environment of driving. In most States no attempt is made to test this important safety requirement. Muscle balance the ability of the two eyes to point simultaneously and easily to the object to be seen. In many persons there is a tendency for at least one eye to point slightly upward or downward (vertical phorias) or to the right or left (lateral phorias). This interferes with good binocular vision and hampers acuity, depth perception, and field of vision. Good night vision is another important requirement, but tests for it are complex and the survey did not include glare-resistance tests. Good night vision for driving depends on three abilities-resistance to being blinded by bright light! quick recovery after exposure to bright light; and ability to see under conditions of low illumination. Pilot survey results Following are the percentages of drivers found to fall below acceptable standards on the major visual requirements tested in the AOA survey which at the stage of the preliminary report had covered 3,000 licensed drivers in 25 States: Dr. Wendell E. Bryan, Denver, chairman of the AOA Committee on Motorists' Vision and Highway Safety, urges caution in generalizing from this pilot survey. However, a broader study is now underway, and the results of it and other related studies indicate that the percentages are close to those that will be found in any cross section of drivers. It should be noted that drivers were tested with their driving glasses if they ordinarily wore glasses for driving, indicating that persons required to wear glasses for driving need periodic examinations, also. The conditions found in the pilot survey are also confirmed by routine examinations of the 75 million adults who visit optometrists and ophthalmologists periodically for visual care. Driving has become so common that the vision of the typical adult may be considered close to the vision of the typical driver. While the pilot study cannot be relied on for precise information on geographical differences, it does indicate wide variation. Most notable is the high rating on visual efficiency of drivers in a State like California where there has long been emphasis on safety and vision as a safety factor. Some rural States, particularly in the Southeast, seem to show about twice as high a percentage of visual problems among drivers as in California. The assumption may be made that, in some States, emphasis on safety and vision has caused drivers to obtain the vision care they need. Conditions can be improved, and are, where action programs are put into effect. Correctability As to the correctability of the vision of those failing the tests, valuable studies have been made by Dr. H. W. Hofstetter, director of the Division of Optometry, Indiana University. From studies of 332 clinic patients, he estimates that only three-tenths to six-tenths of 1 percent of a large cross section cannot be corrected to meet the requirement of acuity (20/40 Snellen in the better eye). His report also shows that 96 percent of the driving population can be corrected to 20/20 in the better eye. Drivers with heterophoria can also be greatly assisted by proper professional care, and correction will greatly improve depth perception and field of vision. However, one of the important results of better vision testing and vision care should be to make drivers more conscious of their visual capacities. The driver who knows that he lacks adequate depth perception can compensate for his short coming by being especially cautious in situations where good depth perception is called for. He can learn to look to the side more frequently if he knows that he does not have the peripheral vision he should have. If glare bothers him or if he is abnormally handicapped in low illumination, he may reduce his night driving or reduce his speed. Dr. Bryan says that "vision is as personal as one's fingerprints"; no two eyes are alike, and even less are two pairs of eyes. The driver who cannot meet such minimum standards as used in the AOA survey should have a thorough examination adapted to his particular needs, and correction for his particular requirements. With the aid of the science and art of visual correction plus conscious adaptation to his capacities or lack of them he can do much to prevent himself from being a highway hazard. An action program Individuals, communities, and organizations seeking an action program for traffic safety may direct their activities toward these "vision for driving" goals: 1. Periodic reexamination of the vision of all drivers. Millions of drivers have had their licenses repeatedly renewed since the days when no eye tests were required for licensing; more millions who had an original test have never been tested again, in spite of the fact that aging is the greatest single contributor to poor vision. 2. Thorough vision examinations for accident repeaters. 3. More extensive use of licensed vision specialists as consultants to licensing examiners, traffic courts and other government agencies dealing with highway safety. 4. Adoption of minimum vision standards in the following skills: (a) Acuity in the better eye; (b) Glare resistance: (c) Adaptation to low illumination; (d) Distance judgment; (f) Breadth of field of view; (f) Color vision. 5. Dissemination of more information on the fact that drivers lack necessary visual skills without knowing it; and that almost all shortcomings can be corrected with proper vision care. Voluntary screening, voluntary correction and voluntary caution can bring immediate results that compulsory laws may never achieve. For more details on the survey referred to and the joint program now underway, any of the following major participants may be consulted: Motorists' Vision and Highway Safety Committee, American Optometric Association, 4030 Chouteau Avenue, St. Louis, Mo. Safety Division, the Woman's Auxiliary to the American Optometric Association, 4013 Byers Avenue, Fort Worth, Tex. Women's Division, Automotive Safety Foundation, 200 Ring Building, Washington, D.C. Mrs. O. G. Rushing, Safety Chairman, National Home Demonstration Council, Shawnee, Okla. AMERICAN OPTOMETRIC ASSOCIATION Committee on Motorists' Vision and Highway Safety: P. N. DeVere, O.D., Trustee Consultant Wendell E. Bryan, O.D., Denver, Colo., Chairman Everett L. Porter, O.D., Belfast, Maine. THE OPTOMETRIST AND SAFE DRIVING INTRODUCTION Without a doubt the practicing optometrist is the most frequently consulted professional man on matters of eligiiblity for driving. This places on the optometrist a great responsibility for the effectiveness of driver licensing programs in the combating of danger on the highway-public enemy No. 1 in its toll of fatalities, injuries, and physical damage. The following outline is intended as a guide to the optometrist in his daily encounters with this terrible national problem. The information, opinions, and recommendations incorporated in this outline are endorsed by the American Optometric Association Committee on Motorists' Vision and Highway Safety as representing the best and most consistent views of leading researchers and recognized authorities. 1. ADVICE TO THE PATIENT WHO DRIVES The optometrist should discuss willingly and frankly the driving problems of the patient in terms of: (a) Glare, or difficulty in seeing under conditions of bright, stray, or rapidly changing illumination. (b) Poor vision in dim light. (c) Poor central acuity, or failure to discriminate signals, road signs, and small hazards. (d) Poor peripheral vision, or failure to detect the existence of hazards originating peripheral to the point of regard. (e) Poor color vision, or failure to interpret correctly signals and signs employing color schemes. (f) Diplopia, resulting in misjudgment of direction of approach of objects in the field of vision. (g) Lack of ability to judge distance and depth accurately. (h) Difficulty in adapting to changes in fixation distances. 2. THE PHILOSOPHY OF DRIVER LICENSING TESTS It should be emphasized and reemphasized that it is not the basic purpose of license tests to eliminate drivers, but rather that the tests are intended to enforce the maintenance of the best possible driving skill and attitude on the part of each driver. Very few persons are unable to qualify under even the highest existing licensing standards. The great majority of disqualifications are due to negligence and unwillingness to take the steps to comply. 3. THE RELATIONSHIP OF VISION TO SAFE DRIVING Vision bears a relationship to safe driving analogous to that of good brakes, adequate road markings, good highway design, and knowledge of the rules of the road. None of these factors assures safety or good driving. But, they are prime factors which make good driving possible. The driver with superior vision and superior equipment who exploits these advantages is a greater hazard on the highway than the less fortunate driver who recognizes and respects both his own limitations and those of fellow motorists. Such complexities in the relationship of good vision to safe driving have made conventional statistical analyses relatively meaningless. 4. SERVICE TO DRIVER EXAMINING PERSONNEL Perhaps the greatest single problem that licensing agencies face is that of maintaining good rapport with wary and belligerent applicants. Such persons often exaggerate unfortunate errors and misjudgments that may creep into the routine licensing procedures and thereby undermine the objectives of the total licensing programs. The optometrist is in the best position to minimize this problem by: (a) Getting acquainted with the driver licensing personnel in his community, discussing such problems as they arise, and making his consultatory services available. (b) Becoming personally familiar with the visual licensing procedures and requirements of his State. (c) Enlisting the cooperation of his fellow optometrists in the development of a helpful attitude toward the driver licensing personnel. (d) Encouraging the establishment and maintenance of uniform testing conditions not only in licensing stations but also in optometric offices consulted by examinees. (e) Preparing his patients for the driver tests, letting them know what to expect, and explaining to them the problems of reliability of vision test scores. He should not tell a patient that he will pass or fail; rather, he should simply tell the patient how he can expect to do if his visual responses at the licensing center are the same as in the optometrist's office. Discrepancies between the license examiner's findings and the optometrist's findings should be resolved by retesting and consultation, not by presumptive discrediting of the procedures employed. (f) Giving due credit to the licensing personnel for excellence of work and their conscientious administrative efforts. In particular the optometrist must respect the professional responsibility of the licensing personnel to make the decision to grant or deny a license to drive. The optometrist's contribution is that of implementing its validity and effectivity. 5. PROFESSIONAL RESPONSIBILITIES FOR SAFE DRIVING In his professional capacity the optometrist must assume the same type of responsibility toward safe driving as a cooperative objective as is normally shared, for example, by the highway engineer, the automobile designer, the traffic control agencies and driver education personnel. In this role he should be studiously familiar with research studies and authoritative evaluations of vision as a factor in driving. He should be prepared to give reliable information and advice to legislative, judicial, and regulatory agencies responsible for establishing laws, standards, and procedures involving vision in driving. |