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British Medical Bulletin Advance Access originally published online on August 20, 2008
British Medical Bulletin 2008 87(1):163-174; doi:10.1093/bmb/ldn028
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Visual function and fitness to drive

Aachal Kotecha*,{dagger},{ddagger}, Alexander Spratt§ and Ananth Viswanathan

{dagger} Department of Optometry and Visual Science, City University, London, UK
{ddagger} NIHR Biomedical Research Centre, Moorfields Eye Hospital and Institute of Ophthalmology, London, UK
§ Department of Ophthalmology, Royal Free Hospital, London, UK
Glaucoma Service, Moorfields Eye Hospital, London, UK

* Correspondence to: Dr Aachal Kotecha Department of Optometry, City University, London City University, Northampton Square, London EC1V 0HS, UK. E-mail: aachalkotecha{at}googlemail.com

Introduction: Driving is recognized to be a visually intensive task and accordingly there is a legal minimum standard of vision required for all motorists. The purpose of this paper is to review the current United Kingdom (UK) visual requirements for driving and discuss the evidence base behind these legal rules. The role of newer, alternative tests of visual function that may be better indicators of driving safety will also be considered. Finally, the implications of ageing on driving ability are discussed.

Sources of data: A search of Medline and PubMed databases was performed using the following keywords: driving, vision, visual function, fitness to drive and ageing. In addition, papers from the Department of Transport website and UK Royal College of Ophthalmologists guidelines were studied.

Areas of agreement, areas of controversy, growing points, areas timely for developing research: Current UK visual standards for driving are based upon historical concepts, but recent advances in technology have brought about more sophisticated methods for assessing the status of the binocular visual field and examining visual attention. These tests appear to be better predictors of driving performance. Further work is required to establish whether these newer tests should be incorporated in the current UK visual standards when examining an individual's fitness to drive.

Keywords: driving • vision • review

Accepted for publication August 1, 2008.


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