How good are we at assessing driving visual fields in diabetics?

Pearson, Andrew; Keightley, S J; Casswell, A G

doi:10.1038/eye.1998.243

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…6 • 13 More recently, it has been suggested that a 12% failure rate may be expected after bilateral PRP, the risk being greater in type II diabetics.lO In addition, there may be substantial differences in the assessment of driving fields between consultants and the Visual Standards Sub-committee (VSSC), with more cases passing when the fields were assessed by the VSSc. 9 Previous studies have documented a decrease in retinal sensitivity after laser treatment of the macula when uni-ocular fields were assessed. Central 30° visual field sensitivity has been noted to decrease after diode, YAG and krypton laser treatment in diabetics with maculopathy.…”

Section: Discussionmentioning

confidence: 99%

Passing the DVLA field regulations following bilateral macular photocoagulation in diabetics

Tong

Vernon

2000

Eye

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Maculopathy is relatively common in diabetics, particularly those with type II disease. 1 Macular laser treatment has been shown to preserve the acuity of many of these patients.2 At present any patient who has had laser treatment in both eyes is required by the Driver and Vehicle Licensing Agency (DVLA) of the UK to undergo a binocular field test. 3 Whilst it is well known that patients who have had bilateral pametinal photocoagulation (PRP) may fail such a test, 4-6 and bilateral paracentral scotomata following macular laser treatment can cause a failure, 6 no case series of patients who have undergone macular treatment without PRP has, to our knowledge, been studied.The purpose of this study was to ascertain the frequency and reasons for any failure of binocular driving fields after bilateral macular laser treatment performed according to a set protocol by a team working in a diabetic retinal clinic. Patients and methodsThe patients who had undergone bilateral macular laser treatment, but no PRP, under a single consultant's care between April 1994 and April 1998 were identified from the laser register and their case notes subjected to study.In cases where the binocular visual acuity was not recorded in the case notes, patients with a monocular best corrected visual acuity of 6/12 or better in each eye of 6/9 or better in one eye at the last clinic visit were included. These patients were included because they were likely to pass the visual acuity criteria for driving set by DVLA. (In the clinic situation this translates to a binocular Snellen visual acuity of 6/10 or better in the best possible lighting.) Macular laser was defined here as argon retinal laser photocoagulation applied to areas within a disc diameter from the centre of the fovea and possibly outside this area but not anywhere peripheral to the temporal arcades. This may be photocoagulation of microaneurysms or grid laser treatment to areas of retinal oedema or both. Grid laser involves L. Tong

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Section: Discussionmentioning

confidence: 99%

Passing the DVLA field regulations following bilateral macular photocoagulation in diabetics

Tong

Vernon

2000

Eye

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“…some patients may be unable to drive after surgery due to loss of night and peripheral vision [36,41]. Moreover, patients undergoing laser photocoagulation may experience immediate worsening after the intervention [1].…”

Section: Introductionmentioning

confidence: 99%

Effect of calcium dobesilate on progression of early diabetic retinopathy: a randomised double-blind study

Ribeiro¹,

Seres

Carneiro

et al. 2006

Graefe's Arch Clin Exp Ophthalmol

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“…Paradoxically some conditions require treatment in order to pass driving criteria which then are failed because of iatrogenic VF loss, for example hippocampal surgery or vigabatrin therapy in the treatment of epilepsy [2, 26, 27, 80, 100, 119, 123, 145, 154, 155, 173]. These hazards need to be discussed with the patient prior to the intervention.…”

Section: Disorders With Pcsmentioning

confidence: 99%

“…Iatrogenic causes of PCS have been reported most frequently as a consequence of ophthalmological surgery (laser photocoagulation, optic nerve sheet fenestration, PRK/LASIK refractive surgery, retinotomy and vitrectomy) [6, 19, 20, 23, 26, 27, 34, 46, 47, 80, 119, 136, 147, 151,154,155,156, 166, 190, 203]. Other procedures associated with iatrogenic VF loss include radiation and ENT surgery of the sinuses, neuro- and cardiovascular surgery [42, 87, 103, 108, 123, 137, 153, 162, 183, 188, 200].…”

Section: Disorders With Pcsmentioning

confidence: 99%