New York's Low Vision Program relies on this eye report for drivers whose corrected vision is worse than 20/40 but no worse than 20/70, and for telescopic lens wearers. The examiner records acuity, the 140-degree binocular field, the cause of vision loss, stability, a re-evaluation interval and recommended restrictions. Without it, the driver may not be able to renew and may be suspended.
A physician, ophthalmologist or optometrist completes the practitioner section after an exam within the last 60 days; the patient completes the identity section and, for a first telescopic evaluation, signs the training certification.
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Eye Test Report for Medical Review Unit
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A physician, ophthalmologist or optometrist, based on an examination performed within 60 days. The practitioner signs, prints their name and certificate or license number, and marks whether this is an initial evaluation or a re-evaluation.
Item 8 offers day driving only, a full-view mirror, no limited access roads, or none. Item 6 sets re-evaluation every six months or every year, item 7 asks whether the condition is stable, and item 9 asks whether it would interfere with safe driving, with an explanation if yes.
Through the telescopic portion, acuity of at least 20/40 in either or both eyes; through the carrier lens, at least 20/100; and a total horizontal binocular field of at least 140 degrees without field expanders. The driver must also pass a road test wearing the telescopic lenses if they have not already done so.