169) A 77 year old woman is brought by her son for evaluation in your office for excessive forgetfulness. Her son discovered that the patient has become increasingly forgetful over the last two years. She has difficulty managing her finances. She lives alone, drives her own car and prepares her own meals. As per son, several recent new dents were noted on her mother’s car. She is dressed well and is comfortable. Visual acuity on examination is 20/100 in both eyes and is partially corrected with glasses. She also has a fixed visual field deficit that is persistent for past one year due to a cerebrovascular accident. Rest of the physical including sensory and motor functions are grossly normal. She scores 25/30 on Mini-Mental Status examination.
The most appropriate recommendation regarding her driving at this time:
A) Limit driving to day-time only
B) Unrestricted driving
C) Complete cessation of driving
D) On-Road performance based driving test
E) Adaptive devices for safe driving
Archer USMLE Step 3 Blog 
dddddddddd
d
d
c i guess. if pt cant see properly she cant drive. it would be too dangerous for her to be on road. already she has lot of dents on car if no stopping her now she would die in an accident.
Who are you to decide wether she is able to drive or not. Do you issue a driver’s license for all your patient’s? Let her get the On ROAD performance based driving test! Just kidding man.. the answer is “D”
i think its C
Ans.: E
The dents on her car because of the visual field defect that she got from the previous CVA & not because of dementia ,, so no need to stop her from driving …
On-Road testing should be done when there is mild dementia a score of 24 or less…. Also in mild dementia we may consider recommendation for driving only in daylight or driving in familiar routes…
Ans. C
c???
what is the correct answer
Answer is E. Patient has viual impairment. Please check http://webeye.ophth.uiowa.edu/dept/service/lowvis/driving.htm
a) is not correct, because she cannot drive when head light is required, it can be rainy day also. I think E is the best answer.
D
E
Adaptive device for visually impaired
No road test until she has bioptic telescope aids mounted on her lenses to correct for the visual field defect. This will magnify her field of vision 1.7 to 8 times that of normal. Then she can go for road test. Will you sit in the same vehicle with someone who has a visual field defect?
http://www.ehow.com/info_8356494_driving-schools-visually-impaired.html
I just asking out of curiosity. Won’t it be funny if one is a driving instructor and during a driving test, a 77 year old granny mentions just casually while driving, “my doctor says I can not see part of the road”.
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