An AOP explainer on... campaigning for safe driving vision

Adeley’s subsequent Prevention of Future Deaths Report, which was submitted to the Secretary of State, Adeley outlined the cases of Peter Westwell, Mary Cunningham, Grace Foulds, and Anne Ferguson – all killed by drivers with poor eyesight – and warned that the enforcement of visual legal standards for motorists is “ineffective and unsafe.”

While these high-profile fatalities put driving and vision in the spotlight, the challenge has been a known issue at the Association of Optometrists (AOP) for many years and one in which we have campaigned hard to change, with consistent calls to the Government and the Department for Transport through our Don’t swerve a sight test campaign.

At the AOP, our clinical advisers are no stranger to the careful balance that must be struck between patient confidentiality and the broader responsibility to protect public safety when one of our optometrist members are required to report a driver who no longer meets the standard but continues to drive.

It remains one of the top queries we receive and we, along with The College of Optometrists, provide guidance and CPD on when that difficult judgement must be made based on clinical expertise. Our Don’t swerve a sight test campaign to some extent was born out of the common ethical challenge, faced by many healthcare professionals, and not least our members who test the visual acuity of the nation.

But it is the human cost of inaction on these laws that has been the real driving force behind the campaign we have run since 2017. Back in the campaign’s inception, I, among many others were horrified by the case of Poppy Arabella Clarke – how a driver, advised not to get behind the wheel, took the life of a three-year-old girl on her way to nursery. A tragedy.

The reality is, there is currently no requirement in the UK for drivers to have regular sight tests – a system that is clearly out of step and failing the public. For instance, the UK is one of only five countries – out of 27 – that still uses a number plate test to assess driving vision. And one of just three that rely on self-reporting.

“The UK is one of only five countries – out of 27 – that still uses a number plate test to assess driving vision”

The truth is, the reason that this challenge needs addressing is because eyesight changes. Sometimes slowly, sometimes overnight. What was “fine” last year might not be this year. We all know this. And yet we still have a system that ignores it. And as a result, we see cases, time and again, where the rules are flouted by drivers with poor eyesight by intention, but more commonly, and perhaps more worryingly, without knowledge.

If you can go from 17 to 70 without an eyesight check, that’s over 50 years, it is very improbable, if not impossible, that you will not have experienced a change to your vision. And we know that roadside tests demonstrate this – many drivers subsequently fall below the required standard as their eyesight changes over time, often without realising it.

Since that first launch, the AOP has been fully committed to doing two things as part of our Don’t swerve a sight test campaign.

Firstly, it’s been about that crucial message to the public: increasing awareness of the importance of good vision for driving. We have always encouraged drivers to have a sight test every two years, as the best way of ensuring your vision is optimised for driving. Secondly, we call on the Government to fix a system that is not fit for purpose – to make a simple change that would save lives.

We’re not calling for something radical – we’re simply asking that we find a way of effectively implementing the current vision standards for driving. Which is why we developed, alongside The College of Optometrists, our five core principles for achieving this.

As part of this we ask that there is a mandatory requirement for all drivers to submit evidence of an up-to-date sight test at licence application and renewal, every 10 years and then every three years from the age of 70, to align with age-related eye conditions and deterioration in visual function. We concede that this is not a perfect solution, but it will mean that people like Anne Ferguson – killed by a driver who repeatedly failed to self-report his severe cataract to the Driver and Vehicle Licensing Agency – would still be alive.

Don’t swerve a sight test achieved a huge amount of attention when it first launched and has continued to secure national recognition over the years – through the major media players like the BBC, Sky News, Telegraph, Guardian, The Times, by the police force and in Parliament. We have been proud to hold the torch on this issue, but change has only felt real and achievable this year – when for the first time we received a commitment from Heidi Alexander, as Transport Secretary, to review current laws. This has fundamentally been down to our increasingly political focus – to maintain engagement in the House – but a change in officials has also contributed to this, with a perfect storm of pressure from the affected families and Adeley’s welcomed recommendations.

Don’t swerve a sight test has been an important and rewarding campaign to revisit each year. Not least, because at the heart of this is a human story. I have had the opportunity to work with many of the interested parties over the years and as part of that the families, who have campaigned tirelessly so that others do not have to face the same devastation at the hands of a driver who shouldn’t be on the road.

“Don’t swerve a sight test has been an important and rewarding campaign to revisit each year. Not least, because at the heart of this is a human story”

But it is also highly rewarding because it is an issue where we can represent members – as a campaign that has been consistently recognised and appreciated by them for their conversations with patients but also in utilising our toolkits, advice and guidance and other resources in the campaign hub.

Naturally I was thrilled to see Alexander, closely followed by the Health Secretary, Wes Streeting, making a solid commitment to an overhaul of the driving laws, set to be published as part of a new road safety strategy in the autumn. But there is always a healthy degree of cynicism where politics is concerned – what is said versus what is actually delivered. For change to be truly effective and do what’s intended – make UK roads safer – we want to see mandatory sight tests for all drivers, not just those over the age of 70.

It feels too early to speculate on the detail of how vision checks will be integrated into the new strategy, but we recognise that this will be a big change for the profession. With ophthalmology already under pressure, mandating sight testing will only add to the demands on eye care. What is clear is that community optometry will have its role to play – and any additional services will require more of our members, and therefore need secure, sustainable funding.

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Coming up at the AOP

1 OCT Day, 12 October

OT, in partnership with the AOP, will host its four interactive webinars of education dedicated to optical coherence tomography. Book your place here.

2 OCT Day, 12 October

The AOP, with headline sponsor Bausch + Lomb, will host the conference for hospital and specialty optometrists in London. Find out more about HSOC.

3 AOP Council meeting, 12 November

The AOP will hold its next meeting for AOP Councillors in November. Keep an eye on the website for OT’s key takeaways from the session. 

Rewind: A review of AOP activity in the past two months

OT

Consultation: extending medicine responsibilities

The AOP welcomed a consultation from the Department of Health and Social Care into extending medicine responsibilities for optometrists and contact lens opticians. Dr Peter Hampson, optometrist and AOP clinical and policy director, said: “Widening the access of medicines for all optometrists and contact lens opticians will transform the experience for the public.” Read OT’s piece here.

OT

Practice team webinars

On 21 September, OT in partnership with the AOP and the Vision team at Johnson & Johnson as headline sponsor, hosted a day of education for practice staff. Webinars from the day are available to rewatch on-demand through the OT Education library.

 Welcoming the next generation

The AOP has been travelling to optometry schools across the country, welcoming first-year students and highlighting the benefits of membership. Meet the student reps on the AOP’s Instagram page.