Research reveals urgent need for updated vision screening for older drivers

Research indicates an urgent need for updated vision screening policies and safer infrastructure to protect aging drivers.

Older drivers with vision impairment are dramatically more likely to stop driving or avoid challenging road conditions—with severe cases four times more likely to give up driving altogether, a national University of Michigan study finds.

Driving is essential for the mobility, independence and overall well-being of older adults. Unlike previous generations, today’s older adults are driving longer, taking more trips and spending more time on the road. However, vision-related issues can complicate driving.

Based on objective vision testing and nationally representative data, the research highlights a critical gap in road safety policies, as America’s aging population drives more miles than ever before.

Among Americans aged 65 and older, 14% live with either distance vision impairment or contrast sensitivity issues. But the real shock comes in how these conditions reshape driving habits: More than 25% of older drivers with vision impairment stop driving within just one year—compared to only 12% of their peers with normal vision.

Those with moderate-to-severe distance vision impairment face the steepest consequences, becoming four times more likely to cease driving entirely and up to 4.5 times more likely to avoid situations like night driving or busy highways.

What we’re seeing is a cascade effect. As vision worsens, drivers self-regulate—first avoiding complex routes, then quitting altogether. But with driving so tied to independence, these decisions often come too late, after near-misses or accidents.”

Shu Xu, postdoctoral fellow, U-M Institute for Social Research

A flaw in current safety standards

The study challenges long-standing assumptions about vision and driving safety. While contrast sensitivity (the ability to distinguish objects against similar backgrounds) was previously considered the best predictor of driving risk, the data reveals that distance acuity—particularly when combined with contrast issues—is significantly more consequential.

“This isn’t about which test is better,” said Joshua Ehrlich, ISR research associate professor and associate professor of ophthalmology and visual sciences. “It’s about recognizing that many older adults have multiple overlapping vision deficits. Relying solely on standard eye charts at the DMV is like only checking one symptom of a disease.”

For families, the message is clear: Healthy vision is a key part of driving and subtle changes, like struggling with glare or missing exit signs, may indicate potential issues.

On the policy front, researchers suggest key reforms: “vision-aware” road designs (e.g., high-contrast signage) and driver rehabilitation programs to help individuals adjust to declining sight.

“We’re failing older drivers by using 20th-century tests for 21st-century longevity,” Xu said. “A person who can’t see a street sign at dusk shouldn’t have their license revoked—we should improve the visibility of street signs.”

Researchers said this work makes a key contribution to the fields of transportation, vision and aging by addressing significant gaps in the existing literature with strong, nationally representative data.

“Additionally, we incorporate multiple objective vision tests, including both distance visual acuity and contrast sensitivity, making this the first nationally representative study to examine how concurrent vision impairments influence driving cessation and avoidance, offering a more comprehensive perspective,” Xu said.

The group is currently examining transportation alternatives for older adults with vision impairments, with initial data indicating that most lack access to usable transit options.

“When driving stops, isolation often begins,” Xu said. “We need systems that don’t make people choose between safety and survival.”