Maine's Bureau of Motor Vehicles accepts this two-page eye examination report, revised 05/01/2023, from a licensed vision examiner when a driver applies for a license, renews at certain ages or has an eye condition. The examiner records acuity in each eye, total continuous visual field, and any defect, bioptic use or progressive condition, and sets a reexamination interval.
The driver fills in identifying details. A licensed vision examiner completes the rest based on the exam and Maine's Functional Ability Profile rules, then signs with the exam date.
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Eye Examination Form
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No. Telescopic or bioptic lenses may not be used when testing visual acuity, though the examiner can check a box noting the patient uses bioptic telescopic lenses for driving. Field expansion devices are likewise not permitted when measuring the visual field.
The exam date on the form must be within the past 12 months, and BMV will not accept an exam done more than one year before it receives the form. For a renewal, the outside exam may not be done more than a year before the renewal date.
Maine's Functional Ability Profile rules require a continuous horizontal visual field of 110 degrees. The examiner records total degrees on the form and refers to the rules when the field is under 110 degrees or there is field loss after a stroke or brain injury.