The Introduction of Bioptic Driving in the Netherlands

Background: In many US states, people with moderately reduced visual acuity (eg, 20/50–20/200) can legally drive with the aid of a small, spectacle-mounted (“bioptic”) telescope.We conducted a demonstration project to assess the viability of implementing bioptic driving in the Netherlands. In this article, we describe the framework of the project from conception through to realization of our primary objective—the introduction of bioptic driving as a legal option for visually impaired people in the Netherlands. Methods: The project was based on bioptic driving programs in the United States, which were adapted to fit into current driving training and assessment practices in the Netherlands. The project convened a consortium of organizations including the Netherlands Bureau of Driving Skills Certificates, service organizations for the visually impaired, and research departments at universities investigating driving and vision. All organizations were educated about bioptic driving and participating professionals were trained in their specific aspects of the project. Media publicity led to significant interest and helped recruitment that enabled the screening and selection of potential participants. Outcomes: The project demonstrated that people with moderately reduced visual acuity can be trained to achieve an adequate level of proficient and safe driving (as assessed by the local official driving licensing professionals) when using a bioptic telescope for the road conditions in the Netherlands. Based on the successful project outcomes, a request was made to the minister to allow bioptic driving in the Netherlands. This request has been accepted; the legal procedures for implementation are in process

Compensatory Reading Training for People with Homonymous Visual Field Defects:a Randomised Controlled Trial Protocol

Homonymous visual field defects (HVFDs) are among the most common consequences of damage to postchiasmatic brain areas. As many as 80% of the people with HVFDs may suffer from reading difficulties, which can have a severe negative impact on patients’ daily life. These reading difficulties include reduced reading speed, making more errors, skipping words or lines, reduced reading endurance, and having problems understanding or memorising the information that is read.In the Netherlands, rehabilitation centres currently do not offer evidence based training to improve reading difficulties in people with HFVDs. In the past decennia, several interventions have been developed and studied. There is however a need for community-based clinical research with strong methodology to 1) investigate the effects of reading training for people with HVFDs, as well as to 2) provide recommendations for rehabilitation practice. We describe a novel project (2019 – 2024) that aims to establish the effectiveness of two in-practice developed compensatory reading trainings for people with reading difficulties due to HVFDs. Collaborating with two leading centres of expertise for visually impaired people in the Netherlands, a three-arm single-blind randomised controlled trial is being developed, comparing saccadic reading training (‘Vistra’), rotated reading training and a waiting list control group. The goal of Vistra is that people with reading difficulties compensate for the HVFD by adapting their eye movements whilst reading. Rotated reading training aims to reduce the effects of the HVFD by learning people to read in a different, individually tailored direction such as diagonally or vertically.Within the current project, participants with HVFDs will receive initial assessment of visual functions, reading performance, neuropsychological screening and a vision-related questionnaire briefly after referral. Allocation to one of the training groups or the waiting list control group will be done using a tailored minimization technique. At fixed moments, pre- and post training assessments will take place. Participants in the waiting list control group will receive no training in between pre- and post-assessments. Follow-up interviews will take place three months after post-assessment. Primary outcome measures will focus on reading performance (e.g. reading speed, reading comfort, and reading comprehension). Secondary outcome measures are vision-related quality of life, social participation and reading-related activities.The project will lead to 1) establishing the effectiveness of two reading interventions for people with HFVDs in different reading situations, and 2) enhancing the understanding of reading problems in people with HVFDs and helping healthcare professionals to provide better care

Compensatory Reading Training for People with Homonymous Visual Field Defects:a Randomised Controlled Trial Protocol

Homonymous visual field defects (HVFDs) are among the most common consequences of damage to postchiasmatic brain areas. As many as 80% of the people with HVFDs may suffer from reading difficulties, which can have a severe negative impact on patients’ daily life. These reading difficulties include reduced reading speed, making more errors, skipping words or lines, reduced reading endurance, and having problems understanding or memorising the information that is read.In the Netherlands, rehabilitation centres currently do not offer evidence based training to improve reading difficulties in people with HFVDs. In the past decennia, several interventions have been developed and studied. There is however a need for community-based clinical research with strong methodology to 1) investigate the effects of reading training for people with HVFDs, as well as to 2) provide recommendations for rehabilitation practice. We describe a novel project (2019 – 2024) that aims to establish the effectiveness of two in-practice developed compensatory reading trainings for people with reading difficulties due to HVFDs. Collaborating with two leading centres of expertise for visually impaired people in the Netherlands, a three-arm single-blind randomised controlled trial is being developed, comparing saccadic reading training (‘Vistra’), rotated reading training and a waiting list control group. The goal of Vistra is that people with reading difficulties compensate for the HVFD by adapting their eye movements whilst reading. Rotated reading training aims to reduce the effects of the HVFD by learning people to read in a different, individually tailored direction such as diagonally or vertically.Within the current project, participants with HVFDs will receive initial assessment of visual functions, reading performance, neuropsychological screening and a vision-related questionnaire briefly after referral. Allocation to one of the training groups or the waiting list control group will be done using a tailored minimization technique. At fixed moments, pre- and post training assessments will take place. Participants in the waiting list control group will receive no training in between pre- and post-assessments. Follow-up interviews will take place three months after post-assessment. Primary outcome measures will focus on reading performance (e.g. reading speed, reading comfort, and reading comprehension). Secondary outcome measures are vision-related quality of life, social participation and reading-related activities.The project will lead to 1) establishing the effectiveness of two reading interventions for people with HFVDs in different reading situations, and 2) enhancing the understanding of reading problems in people with HVFDs and helping healthcare professionals to provide better care