Visual function and fitness to drive

Abstract

Current UK visual standards for driving are based upon historical concepts, but recent advances in technology have brought about more sophisticated methods for assessing the status of the binocular visual field and examining visual attention. These tests appear to be better predictors of driving performance. Further work is required to establish whether these newer tests should be incorporated in the current UK visual standards when examining an individual's fitness to drive.

Practical landmarks for visual field disability in glaucoma

“…This suggests that the ‘true’ sensitivity and NPV of the BEMD to assess LFTD is even higher, since the IVF surrogate test is more stringent than the actual Esterman test. Furthermore, the IVF offers advantages over the Esterman test because it is possible to measure a patient's reliability (fixation losses),24 and it is based on a threshold test rather than a supra-threshold test. It does not, however, assess thresholds beyond 20° from fixation, which is a notable flaw for assessing the VF required for driving, in general.…”

Comparison of the monocular Humphrey visual field and the binocular Humphrey esterman visual field test for driver licensing in glaucoma subjects in Sweden

“…In the UK a driver should have a binocular horizontal visual field of at least 120° assessed using a Goldmann III4e target or similar and have no significant defect [7]. The European Union Member States have their individual driver’s license requirements and guidelines, but the European Union regulations can potentially overrule these.…”

Through the Looking Glass

“…47,70 They also have deficits in hand-eye coordination. 47 Visual processing including spatial, temporal, and color resolution, as well as, visual acuity and contrast sensitivity are diminished in low light 71 and these reduced visual functions in glaucoma may lead to increased difficulty when night driving. This may explain why people with glaucoma drive less at night.…”