Medical Conditions and Driving: A Review of the Literature (1960 – 2000)
TRD Page
Foreword
Acknowledgements
Section1: Introduction
Section 2: Vision
Section 3: Hearing
Section 4: Cardiovascular
Section 5: Cerebrovascular
Section 6: Peripheral Vascular
Section 7: Nervous System
Section 8: Respiratory
Section 9: Metabolic
Section 10: Renal
Section 11: Musculoskeletal
Section 12: Psychiatric
Section 13: Drugs
Section 14: Aging Driver
Section 15: Anesthesia and Surgery
Appendix A
List of Tables
List of Figures
download PDF

Appendix A
Preliminary Guidelines for Physicians:
Assessing Medical Fitness-to-Drive

Section 2: Vision

  1. Acuity

  2. Visual Field
    a. Hemianopia / Quadrantanopia
    b. Monocular Vision

  3. Miscellaneous Conditions
    a. Aphakia
    b. Cataracts
    c. Glaucoma
    d. Color Blindness
    e. Poor Night Vision
    f. Conjunctivitis and other Anterior Eye Infections
    g. Diplopia
    h. Nystagmus
    i. Ptosis
    j. Telescopic Lens

  4. Contrast Sensitivity-see Section 16-Areas Under Investigation

Preliminary Guidelines for Medically-At-Risk Drivers
Section 2: Vision

Function/Condition

1. Acuity

Visual acuity must be measured with both eyes open while wearing any corrective lenses usually worn for driving.

Eye sight requirements:
Not less than 20/40 with both eyes open and examined together.

2. Visual Field

The minimum field of vision for safe driving is defined as a field of at least 120degrees on the horizontal plane.
Note: Visual field assessment using the automated vision testers typical at Department of Motor Vehicles may be insensitive to some visual field defects.

     a. Hemianopia/
        Quadrantanopia

Typically should not drive, however, should be assessed by the driver licensing authority on an individual basis. An ophthalmologist’s report should be submitted to the driver licensing authority, which may then consider a conditional license.

     b. Monocular Vision

No restrictions for monocular drivers if standards for visual acuity and field of vision are met.

3. Miscellaneous Conditions:

     a. Aphakia

May drive if meets the acuity criteria. Specialist opinion recommended.

     b. Cataracts

With contact lens or intraocular lens following cataract removal: May, after full recovery, qualify for a license if able to wear contact lenses or have had an intraocular lens transplant. The surgeon should advise the patient when it is safe to resume driving.

     c. Glaucoma

May drive if an optometrist’s or ophthalmologist’s report is obtained stating that the visual acuity and visual field criteria are met. Must be subject to annual evaluation of vision and visual fields by an eye care specialist, with the report forwarded to the licensing agency.

     d. Color Blindness

No restrictions for deficits in color vision if standards for visual acuity and field of vision are met.

     e. Poor Night Vision

Should not drive at night or under other low light daytime conditions.

     f. Conjunctivitis and
         other Anterior Eye
         Infections

Physician should advise re: driving if condition is severe enough to interfere with eye comfort or vision.

     g. Diplopia

Should not drive in the early stages of diplopia. If the diplopia can be completely corrected with a patch or prisms to meet the standards for visual acuity and visual field, the driver may be eligible to drive on specialist recommendation.

     h. Nystagmus

No restrictions if standards for visual acuity and field of vision are met.

     i. Ptosis

Individuals with fixed ptosis can drive provided lids do not obscure the pupil of both eyes and the applicants are able to meet the standards for visual acuity and field without having to hold their head in an extreme position.

     j. Telescopic Lens

The ability to drive safely using bioptic lenses should be demonstrated by a road test.

 

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