Implementing the current vision standards for driving in the UK, produced by the Association of Optometrists and The College of Optometrists

Executive summary

The current laws around how the vision standards for driving are implemented are not fit for purpose. We, along with The College of Optometrists, have continually called for a change to the law to help make sure our roads are as safe as possible for all. Our campaigns have, in the past, had a sharp focus on reminding all drivers to have regular sight tests – as the easiest way of assuring their eye health and making sure that their visual acuity meets the legal standard and is road safe while the law continues to fail road users.

Following the inquest brought by the Senior Coroner for Lancashire, Dr James Adeley, into four pedestrians who were killed in three road traffic collisions where the drivers’ poor eyesight was a significant contributor, it is time to act. Now with, Dr Adeley’s Prevention of Future Deaths report, alongside data and evidence gathered that shows the current self-declaration system to be failing, we have jointly developed five principles to ensure current vision standards for driving are implemented, and working for the public – requiring small changes to existing legislation that would have a considerable impact to make our roads safer for all.

The current standard

A UK driver interacts with the Driver and Vehicle Licensing Agency (DVLA) or Driving and Vehicle Agency (DVA) at several key stages throughout their lifetime on the issue of vision for driving.

This includes:

• Applying for a provisional licence and receiving a full driving licence upon passing a practical test – vision correction should be declared and a number plate test carried out as part of the driving test  
• Licence renewal every 10 years – includes medical declarations
• Licence renewal every three years for drivers over 70 – includes medical declarations.

DVLA vision standard

In Great Britain, there is a dual standard that must be met:

• Drivers must be able to read a standard size number plate (with glasses or contact lenses if necessary) from 20.5 metres (67 feet) or 20 metres (65 feet) where narrower characters 50mm wide are displayed
• Drivers must meet the minimum eyesight standard for driving by having a visual acuity of at least decimal 0.5 (6/12) measured on the Snellen scale (with glasses or contact lenses, if necessary) using both eyes together or with one eye if they have sight in one eye only
• Drivers must also have an adequate field of vision
• Drivers must wear glasses or contact lenses every time they drive if they require them to be able to meet the DVLA’s Standards of vision for driving
• Drivers must tell the DVLA if they have any problem with their eyesight that affects both of their eyes, or the remaining eye if they only have one eye.

DVA vision standards

• Drivers must be able to read a standard size number plate (with glasses or contact lenses if necessary) from 20.5 metres (67 feet) or 20 metres (65 feet) where narrower characters 50mm wide are displayed
• Drivers must also make sure that they have an adequate field of vision. The field of vision standard requires a specific width of visual field without significant defects in the sensitive central area. If a driver has total loss of sight in one eye they must not have any defect in the visual field of the remaining eye.

Our recommendations: five core policy principles for implementation

1. Mandatory for all drivers to be responsible for providing evidence of a valid sight test at license application and renewal to ensure accurate and objective assessment of visual acuity and eye health

The sight test includes a vision assessment and eye health examination for all drivers at initial application, at every renewal (every 10 years and then every three years from age 70, to align with age-related eye conditions and deterioration in visual function):

• The sight test is a regulated function delivered by registered optometrists predominantly through community optometry practices on the High Street which is accessible and consistent across the UK
• The sight test ensures that the Snellen visual acuity standard for driving is assessed accurately and objectively in standardised conditions
• The sight test enables early detection (and treatment or referral, if appropriate) of notifiable (by driver) eye conditions that may otherwise be asymptomatic.

Impact: This policy offers a significant improvement on the current system which is entirely dependent on self-declaration of meeting the vision standards for driving and over-reliance on the number plate test. Further, many eye conditions, do not have many (if any) symptoms in the early stages. This means drivers may unknowingly not meet the vision standards or may have a reportable eye condition, while larger improvements are possible this initial change will introduce a significant risk reduction in the risk of vision-related current and future driving accidents.

2. Strong emphasis on attending regular sight tests between renewals

Regular sight tests provide assurance that visual acuity continues to meet the vision standards, and eyes are healthy:

• Early detection of eye disease means drivers can access treatment (if appropriate) and avoidable sight loss is prevented
• Where significant refractive error is detected, visual correction can be provided to improve visual acuity
• Early treatment of eye conditions and intervention with visual correction can enable and provide drivers with reassurance they meet the visual standards and can continue to drive.

Impact: Regular sight tests are critical to reducing the current and future risk of driving accidents. Clear and sustained public communication (eg on application and renewal forms) on the vision standards and the benefits of regular sight test is needed to reach those who do not currently attend.  Not only can driving safety be improved, but when an issue is identified, for example a cataract, advice and counselling can be provided to ensure that the person understands how they can take action to continue to drive.

3. Referral to DVLA following failure to meet the driving vision standard in the sight test

If following a sight test a driver cannot meet the 6/12 required Snellen standard, has a visual field defect or notifiable eye condition, the optometrist would follow the current system:

• Inform the driver of the results, advise them not to drive and remind them of their duty to notify the DVLA; supported by agreed sector guidance
• The DVLA will investigate further and offer follow-up testing where appropriate at an approved provider – including an Esterman test.

Impact: This policy ensures that drivers who fail to meet the required minimum standard during their appointment in a optical practice are evaluated using more robust methods, but also reminds drivers of their responsibility to ensure they are fit to drive

4. Continued public awareness and education about driver responsibility between renewals

Drivers are reminded of their legal and ethical responsibility to:

• Ensure they always meet the vision standards and aware of what they are
• What to do should they have any visual or eye health concerns (contact their local optometrist for advice in the first instance)
• Have a sight test every two years, or more often if recommended by their optometrist
• Notify DVLA if they fail to meet the vision standards for driving
• Declare any notifiable eye condition that may affect driving at any time, not just at renewal.

Impact: Supporting drivers to take ownership of the decision making process avoids or reduces the perception of this process being over bureaucratic. By promoting the value of early intervention, it is hoped that drivers will embrace the maintenance of good vision and eye health, while having an added benefit of keeping them driving safely for longer. By raising public awareness, drivers will hopefully be motivated to ensure they attend for regular sight tests to avoid concerns about licence renewal.

5. Reinforce reporting guidance for primary eye care optometrists conducting the sight test on drivers

Where it is apparent that a driver who fails to meet the driving vision standards is unlikely to notify the DVLA, they intend to drive, or are observed them continuing to drive, optometrists should be supported to make a direct disclosure. This can be achieved by:

• Utilising existing guidance from healthcare regulators (eg GOC) and professional organisations on when and how to report
• A DVLA-defined reporting mechanism to support healthcare professionals to make direct disclosures.

Impact: We are aware that healthcare professionals need the right support to determine what represents a danger to the public and when it is appropriate to make a direct disclosure to the DVLA. This can help provide healthcare professionals with reassurance and removes ambiguity when they are acting in the public interest and their decision outweighs their duty to patient confidentiality.