Driving and vision

We believe vision checks should be introduced on licence application and as a legal requirement at least every ten years

Summary

You need good vision to drive safely, and drivers should get their sight tested regularly.

The current rules on driving and vision are too weak. After the driving test, the law doesn’t require most drivers to have another vision check ever again¹ – and the UK’s number plate test isn’t fit for purpose. The law should require all drivers to have their vision checked every time they renew their driving licence.

Without better rules on driving and vision, it would be counter-productive to introduce automatic reporting to the DVLA where a driver does not meet the driving standard in a single sight test. That could deter drivers from getting their eyes tested altogether, making the roads more dangerous.

What we're calling for

All drivers should get their sight tested at least every two years, or more often if their optometrist recommends
As a fall-back, all drivers should be legally required to have their vision checked when they first apply for a licence, and when renewing their driving licence – every ten years for most people, and every three years for those over 70
That check should involve standardised reliable tests, rather than the inadequate number plate test
Unless and until the law changes, drivers should remain responsible for notifying the DVLA if they fail to meet the current driving standards. Without universal vision checks, requiring optometrists to notify the DVLA automatically would deter drivers from getting their sight tested at all, making the roads more dangerous

What's happening

Safe driving depends on good vision. Everyone should have their sight tested at least every two years, or more often if their optometrist recommends it. This is particularly important for drivers, because drivers with uncorrected vision problems present a risk to all road users, including themselves.

Poor vision causes many road accidents. We don’t know exactly how many, because accidents can be caused by a combination of factors, including tiredness and distraction as well as poor vision². And there’s no requirement for a driver’s vision to be checked when an accident happens. But a 2012 study³ estimated that over 2,000 drivers in the UK were involved in accidents due to poor vision, causing nearly 3,000 casualties.

Better rules on driving and vision would help to deal with this problem. Drivers in the UK only have to pass the number plate test, a basic check of their vision, as part of the driving test . And after that, only the drivers of large lorries and buses have to get their vision checked regularly. From the age of 70 all drivers have to confirm every three years that they are fit to drive, but they don’t have to show that their vision has been checked. The police have powers to revoke a driver’s licence if they can’t pass the number plate test when stopped, but the use of this power varies from force to force. In any case, the number plate test is not a reliable indicator of whether vision is good enough to drive. And that means people in the UK keep driving when their vision is too poor to be safe.

These rules are weaker than those in many other countries⁵ – for instance, most European countries require a proper eye test carried out by an eye health professional.

What needs to change

Regular vision checks

The most important change that’s needed is a legal requirement for all drivers to have their vision evaluated regularly. Ideally this should happen every two years, because changes to vision can be gradual, and a driver may not realise that their sight has become too poor for driving. For example:

Cataracts – which are particularly common in older people – can form slowly, cause blurring which can’t always be corrected by glasses, and increase the risk of involvement in an accident⁶

People with glaucoma tend to overestimate their field of vision⁷

At a minimum we think a vision check should be legally required whenever a driver renews their licence – usually every ten years, but every three years for people over 70. Drivers whose vision has deteriorated to an unsafe level during that period could then be identified, referred for more testing if necessary, and either helped with glasses or contact lenses, or advised on their options if their vision can’t reach the necessary standard for driving with correction.

Accurate assessment

The way drivers’ vision is assessed also needs to change. The number plate test isn’t necessarily a reliable indicator of whether someone can drive safely because it does not check all the relevant aspects of visual function. So, someone may pass the current driving standard without having good enough vision to drive safely. And the result of the number plate test can’t be checked in a test environment with consistent results^8/9.

The solution is to replace the number plate test with a modern and reliable evaluation process.

Compulsory reporting to the DVLA?

Understandably, many people think that any driver who doesn’t meet the required standard in a sight test should be reported automatically to the DVLA. But until the law is changed to require regular checks of all drivers’ vision, compulsory DVLA reporting would make things worse, not better because it would only affect those drivers who choose to have a sight test voluntarily.

Optometrists already can and do notify the DVLA if they have a patient who insists on continuing to drive when their vision doesn’t meet the required standard. The decision to notify the DVLA can be a difficult one, which involves balancing the duty of patient confidentiality with wider obligations to consider the safety of the patient and others. Our members are used to exercising their clinical judgement and making these difficult decisions.

There is already strong evidence that some drivers avoid having a sight test because of worries about what the results might be. In a 2014 survey by the road safety charity Brake¹⁰, an alarming 19% of drivers said they had put off going for a sight test after noticing a problem with their vision. This is unfortunate, because most concerns about a change in vision can be resolved with appropriate glasses or contact lenses.

Our members work with people who have vision problems every day. And they know that without universal vision checks, compulsory DVLA reporting would deter many more drivers from getting a sight test at all. Those drivers wouldn’t get the help they need to correct their vision – and ultimately, this would lead to more deaths and injuries on the roads.

References

This applies to drivers of private vehicles and light commercial vehicles (Group 1). Drivers of large lorries and buses (Group 2) must have a check every five years after age 45.
Owsley C & McGwin G Jr (2010) Vision and driving. Vision Research 50:2348-661
RSA Group (2013) Fit to Drive: a cost benefit analysis of more frequent eyesight testing for UK drivers
Recently, to align with the European Directive for driving, the UK DfT added the requirement that drivers should also have 6/12 Snellen vision as well as read the number plate, but there is no expectation of being tested against this standard, except drivers of large lorries and buses
European Council for Optometry and Optics (2017). Visual Standards for driving in Europe
Owsley C, et al. (2001) Visual risk factors for crash involvement in older drivers with cataract Archives of Ophthalmology, 119(6), 881-887.
Smith ND, Crabb DP & Garway-Heath DF (2011) How Does Glaucoma Look? A Study of Patient Perception of Visual Field Defects. Investigative Ophthalmology & Visual Science, 52(14), 4414-4414
Kiel AW, Butler T, Alwitry A (2003) Visual acuity and legal visual requirements to drive a passenger vehicle Eye, 17 579-582.
Charman WN (1997) Vision and driving – a literature review and commentary Ophthalmic and Physiological Optics, 17 371- 391
BRAKE (2014) Driver eyesight survey

Read the rest of AOP position statements

November 2018