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Background: In Europe, driving a passenger car is prohibited if binocular best corrected visual acuity (BCVA) is below 0.5 (20/40). Some US states allow people with reduced visual acuity to use a bioptic telescope system when driving. The aim of our study is to introduce a bioptic telescope system for driving in the Netherlands and to investigate whether it enables people with reduced visual acuity to gain sufficient practical fitness to drive in a European setting. Results: Out of 378 persons who applied for information following media attention for the project, 160 candidates volunteered to participate. Based on the available information, 36 subjects (binocular BCVA: 0.16-0.5 [20/125-20/40]) were invited for assessment (vision, mobility, cognitive function, and driving skills). Of these, 16 did not meet the inclusion criteria and 2 decided not to participate. The remaining 18 subjects were trained in the use of a monocular bioptic telescope (3× magnification). They all completed the predriving training successfully and received driving lessons from specialized professional driving instructors. Eventually, 9 subjects passed the official on-road test of practical fitness to drive, 7 were excluded after a number of driving lessons, and another 2 withdrew on their own initiative. Conclusion: This is the first study in Europe to prepare subjects with reduced visual acuity to drive with the use of a bioptic telescope system. About 55% of the preselected subjects fulfilled all inclusion criteria. Half of the subjects who entered the bioptic training program passed the official fitness to drive test, demonstrating that they could drive smoothly and safely in Dutch traffic using a bioptic telescope system. [ABSTRACT FROM AUTHOR]