In the US, 80% of the older people living in rural and suburban areas, and driving is their principle means of transportation. Many older drivers are forced to cease driving due to age-related vision loss, which may greatly restrict their independence and mobility. There seems to be an easy and legal solution in 39 states for them to prolong their driving privilege - using the spectacle-mounted bioptic telescopes. In more than 20 states, they simply need to pass the vision test with the telescope in order to renew their licenses. If the problem of vision loss could be solved simply by using bioptic telescopes, it would greatly help to maintain the independence and the quality of life in older age. Otherwise, it could jeopardize the safety of bioptic drivers as well as other people on the road. Bioptic driving, however, is not well understood, and its safety is still a highly controversial issue. Limited studies on bioptic driving accidents have been inconsistent, and it cannot be determined from accident records whether the accidents were due to using the bioptic or not using the bioptic. How bioptic telescopes are actually used in driving, how they should be used, and whether their use results in better or worse driving performance have not been well established based on scientific data. Existing knowledge and training guidelines are based on self-reports from the bioptic drivers and opinions from professionals. Two critical aspects that need to be addressed are the lack of knowledge about bi-ocular visual perception when the bioptic is used and the impact of bioptics on driving safety. Two arms of research are proposed by a team of driving researchers, low vision scientists, driving professionals, rehabilitation specialists, and engineers to address the centerpieces in the bioptic driving debate. One arm is to study bioptic drivers' behaviors and driving performance based on their natural daily driving activities, using a long-term in-car recording system, computerized screening techniques, and user friendly off-line reviewing interfaces that we have developed. Novice bioptic users with prior driving experience will be tested before and after bioptic training. Bioptic drivers will be compared with normally sighted control group based on natural driving and survey. The relationship between bioptic use and driving performance will also be analyzed. Another arm is to specifically investigate the impact of device scotoma on hazard detection in laboratory settings and a driving simulator. In those precisely controlled experiments, detection of realistic hazard appearing in the device scotoma due to bioptic use will be evaluated. The long term objective is to answer the question Is it safe to drive with bioptic?. It is expected that the knowledge gained from the proposed studies may help to understand underlying factors of bioptic driving, prescribe appropriate bioptic telescopes, design better bioptic system, and develop training programs. PUBLIC HEALTH RELEVANCE: By addressing concerns and controversies about bioptic driving, the proposed studies will provide unprecedented evidence from natural driving and controlled laboratory experiments to inform bioptic driving community including patients, low vision researchers, driving instructors and vision rehabilitation specialists. The knowledge gain from this and further research will also help policy makers to set evidence-based regulations that ensure visually impaired people's benefit and also protect millions other drivers on the road.