Background: Eye-care practitioners are often required to make recommendations regarding their patients' visual fitness for driving, including patients with visual impairment. This study aimed to understand the perspectives and management strategies adopted by optometrists regarding driving for their patients with central visual impairment. Method: Optometrists were invited to participate in an online survey (from April to June 2012). Items were designed to explore the views and practices adopted by optometrists regarding driving for patients with central visual impairment (visual acuity [VA] poorer than 6/12, normal visual fields, cognitive and physical health), including conditional driver's licences and bioptic telescopes. Closed- and open-ended questions were used. Results: The response rate was 14 per cent (n = 300 valid responses were received). Most respondents (83 per cent) reported that they advised their patients with visual impairment to ‘always’ or ‘sometimes’ stop driving. Most were confident in interpreting the visual licensing standards (78 per cent) and advising on legal responsibilities concerning driving (99 per cent). Respondents were familiar with VA requirements for unconditional licensing (98 per cent); however, the median response VA of 6/15 as the poorest VA suggested for conditional licences differed from international practice and Australian medical guidelines released a month prior to the survey's launch. Few respondents reported prescribing bioptic telescopes (two per cent). While 97 per cent of respondents stated that they discussed conditional licences with their patients with visual impairment, relatively few (28 per cent) reported having completed conditional licence applications for such individuals in the previous year. Those who had completed applications were more experienced in years of practice (p = 0.02) and spent more time practising in rural locations (p = 0.03) than those who had not. Conclusion: The majority of Australian optometrists were receptive to the possibilities of driving options for individuals with central visual impairment, although management approaches varied with respect to conditional licensing.