• driving
• vision

Many people drive either deliberately or unwittingly with inadequate vision to legally hold a licence.

A survey in Australia showed that 8% of drivers failed the state visual acuity requirements.¹ It is the duty of doctors to let their patients know if they do not fulfil the legal requirements.

In England group I drivers should be able to read a standard number plate at 20.5 metres in a good light using both eyes with correction worn if necessary. They should also have a binocular field of 120 degrees along the horizontal with no significant defect within 20 degrees of fixation in any direction. This should be tested with an Esterman binocular field test. Recent guidelines from the Driver and Vehicle Licensing Agency (DVLA) have changed with regard to visual field interpretation, allowing small areas of field loss within these areas to qualify for a pass for group I licence holders. In particular, patients with static long term field defects, particularly those who have a safe driving history who would previously have failed to meet the field requirements, may still be considered for a licence.²

This prospective clinic based audit is the first to use the licence plate test at 20.5 metres rather than a Snellen chart to quantify the size of the problem in a typical ophthalmology clinic in a district general hospital. The use of a number plate is important since …