This one-of-a-kind comprehensive study highlights the importance of automated testing techniques and the significance of vision screening measures other than standard visual acuity testing for assessing all drivers and, in particular, at-risk drivers and older drivers. Non-automated tests tend to be subjective, time-consuming, costly, and heavily reliant on the experience of the examiner. Due to the high collision, injury, and fatality rates of all drivers in the State of Arizona, and the disproportionate number of at-fault older drivers and collision risks in the States of Arizona and Florida, new and automated screening methodologies and vision standards are now needed to promote road safety, predict visual impairment, and evaluate possible restriction or confiscation of driver's licenses. This study demonstrates that environmental factors and manner of collisions increase in collision involvement for drivers between ages 50 to 59 years in both Arizona and Florida. Drivers age 80 to 89 years in both states are most likely at-fault in collisions compared to all other age cohorts. These results are consistent among drivers cited for collision involvement due to visual defects. These findings, which span an 11-year period from 1991 to 2001, not only apply to Arizona and Florida, two states with some of the largest proportions of older individuals in the United States, but, as a global survey of motor vehicle bureau directors or their representatives in the United States, Commonwealth of Puerto Rico, United Kingdom, Canada, New Zealand, and Australia illustrate, any state, country, province, territory, commonwealth, or nation with an increasing number of older drivers. A pilot study, to follow, ultimately allows for the implementation of effective strategies for screening of visual impairment and eye disease in all Arizona drivers. Snellen acuity, the most widely used vision testing measure, accounts for less than 0.1% of the visual field and fails to quantify contrast sensitivity and color vision (Fink and Sadun, 2004), two of several visual parameters needed for safe driving. It is recommended that at-risk and older drivers in Arizona be tested for vision through a newly designed system of measures provided by two automated tests (to test vision condition and function) and one driving simulator (to assess eye status). Hence, it is integrated into a larger system and additional recommendations are provided as these relate to motor vehicle operation skills and cognition. These automated systems and methodologies may ultimately serve as a prototype of transportation license testing improvements for all other states, countries, and agencies (e.g., aviation, rail, maritime, commercial vehicles, etc.) to follow. Such techniques may also reduce the incidence of fraudulent schemes and issuances of driver's licenses, commercial driver's licenses, and hazardous materials transportation licenses.