Glaucoma and driving
Driving is important to maintain freedom and independence but for our own safety and the safety of others, we do need standards of vision to ensure that we can see well enough to be safe on the roads.
Glaucoma damages the peripheral (off-centre) parts of the field of vision first and does not usually affect the central detailed vision until the late stages of the condition. This peripheral damage can go unnoticed, partly because we use our central vision most of the time and partly because one eye can compensate for the other if the damage is in different areas of the visual field of each eye. The danger comes, especially in driving, when the damaged areas in each eye overlap. Instead of an accurate combined visual picture, the brain fills in the missing parts of the visual image.
The gradual onset and adaption to the loss of vision means there is no awareness of these blind areas but there are potential serious consequences when driving.
The minimum visual standards for driving depend on the type of licence in question.
Hopefully you will find this useful if you are a car or motorcycle licence holders.
You don’t need to tell the Driving and Vehicle Licensing Agency (DVLA) if you are diagnosed with glaucoma in one eye and your other eye has a normal field of vision
You must tell the DVLA if your glaucoma affects both eyes.
Ocular hypertension (raised pressure without visual field loss) does not need to be reported to the DVLA as the visual fields are normal.
DVLA eye test requirements The two standards which are used to assess a driver’s safety are visual acuity and visual field.
When the DVLA is advised of the field loss they will require further details about the vision and may arrange for a field of vision test to be carried out at an approved centre.
Both the visual field test and the visual acuity test must be carried out by an appropriately qualified and trained operator, in a quiet location, free from distraction and with illumination appropriate to the specification for the equipment used.
The procedure works in more than half the eyes operated on to restore and improve drainage. It is most successful if the trabeculectomy operation has been performed recently.
The driver should have good peripheral (off-centre) vision on both sides and no significant defect in the central vision.
The test will be performed with both eyes together and will be different from the test usually performed by optometrists or hospital eye departments. The frames of glasses can interfere with the peripheral vision so take the advice of the testing technician as to whether glasses should be worn for the test or not.
The test results are sent to the DVLA and it is the DVLA which determines whether the standard has been met or not.
The DVLA can only make a decision based on accurate visual field charts. Customers can take up to three visual field tests if the first or second charts do not comply with accuracy standards.A customer can request a copy of the visual field test at the time of taking the test.
The DVLA guidance states the need for the driver to have a binocular horizontal field of vision of 120 degrees minimum with not less than 50 degrees on each side of the centre and no significant field defect either within or encroaching 20 degrees from the centre.
Illustration showing five, 10, 20 and 30 degrees from the centre.
If you do receive a form from the DVLA withholding or revoking your driving licence, this will include the information regarding your right to appeal and advice on the process.
If your visual field test does not meet the required standard, it is possible to seek a second opinion from an independent optometrist, and have a further visual field test at your own expense. The DVLA will consider the best test result. If the independent optometrist test is favourable, the DVLA will allow re-application and will send you for a further test at an approved optician.
If you have any other additional medical information that wasn’t available when a revocation decision was made, DVLA invite customers to submit the additional information and a dedicated team will review it promptly.
The additional information should be sent to: DM Business Support, D7, DVLA, SA99 1ZZ.
Please remember to quote the DVLA reference number at the top of the letter.
A formal appeal to the Magistrates Court of England or Wales, or a Sheriff Court in Scotland, is also available. The time limit varies.
If lodging an appeal in England or Wales, this needs to be done within six months of revocation. The time limit in Scotland is different.A driver must bring the appeal against revocation within three weeks of the decision being made. It is vital that drivers in Scotland use the correct postal address and that they send the information promptly to: DM Business Support, D7, DVLA, SA99 1ZZ. There is a team who will prioritise such cases and will process and respond immediately. Before deciding to formally appeal, do feel free to discuss with your eye specialist or GP to confirm whether or not you have a valid case because if you lose your appeal you may have to bear the costs involved.
Those with sight in one eye only, must meet the same visual acuity and visual field standards as binocular drivers. If there is complete loss of vision in one eye (for car drivers this means light cannot be seen at all) then the DVLA should be advised and driving can only be restarted when the individual has been clinically advised that they have adapted to the condition.
It is important to appreciate that insurance cover may be invalid if an individual fails to meet the medical requirements and if the insured driver with visual field loss in each eye has failed to inform the DVLA of their condition. As long as the DVLA allows continued driving then the insurance companies should not refuse insurance.
It is the driver’s responsibility to advise the DVLA of their condition but the medical profession also has a responsibility and should take action to inform the DVLA if they know that driving is continuing without the driver advising the DVLA.
With both eyes open and with or without glasses or contact lenses, the driver should have a visual acuity of at least 6/12 AND be able to read a standard car number plate at 20 metres. A visual acuity of 6/12 means seeing at six metres what a person with normal vision can see at 12 metres distance.