Drivers’ eyesight Professor Steve Taylor Eye Health Alliance

2. Drivers’ eyesight Professor Steve Taylor Eye Health Alliance

3. Vision and Driving Prof Steve Taylor Professional Adviser to FODO

4. Purpose To demonstrate that drivers’ vision is important and raise issues for discussion Aspects to be covered: • Visual acuity • Visual fields • How assessments are made • Should there be any changes

5. Why consider vision? • Intuitively driving performance must be affected by ability to see – we would not expect someone with no useful vision to be driving • Vision is an important aspect of driving and potentially improving standards could reduce accidents • Accident rate and potential costs • In the UK in 1992 300,000 injuries and 5000 fatalities resulting from road accidents • 1992 Economic costs to UK estimated £5.5 billion • 10% reduction saves £0.55 billion

6. Is there evidence to link road accidents to poor vision? • No really credible evidence because: • Vision data relating to drivers involved in accidents is not recorded routinely • Statistically motor accidents are rare events. • It was estimated that in the US a driver could be expected to travel for 102 years before experiencing a disabling-injury accident, and one is not likely to fall victim to a fatal accident for 3738 years when driving.

7. What information is available? • There is a substantial body of research linking driving performance to visual deficiencies • There is considerable data showing a proportion of the drivers on the roads in the UK do not achieve the statutory requirement

8. Where does this leave us? • Accepting that registered blind drivers should not be allowed onto the road the question is not should vision be assessed? but what level of vision is acceptable? • The EC has already outlined a standard • The following questions are important • How accurately should vision be measured? • How frequently should vision be assessed?

9. Accuracy Directive 2009/113/EC – visual requirements for Group 1 Drivers Distance Vision – visual acuity of 0.5 (6/12) with both eyes together, with corrective lenses if necessary Peripheral Vision – 120 degrees horizontal, 20 degrees up and down. No visual field loss in central 20 degrees If using only one eye, assessment by competent medical authority Standards should be met every time a driver gets behind the wheel!

10. Snellen Chart

11. Visual Acuity Evidence - Effect of vision on processing time Travelling at 50Kph if a road sign is read at 50 metres with normal vision (6/6) Processing/reaction time: • 6/6 vision has 3 secs • 6/12 has 1.5 secs (New EC standard) • 6/18 has 1 second

13. What is the legal requirement? It is an offence to drive at any time with vision below the required standard Where a driver has been assessed as requiring a visual correction to meet the driving standards it is an offence to drive without wearing the correction

14. Wearing habits in sample

15. In brief • Visual acuity decreases naturally with age from about 60 • The number of drivers who fail to reach an acuity of 6/12 without spectacles increases with age from 50 • Drivers are more inclined to not wear their spectacles for driving when needed to meet the standard after the age of 40

16. Retinitis pigmentosa

17. Macula Degeneration

18. Glaucoma

19. Field of Vision • This assesses the boundaries of vision to the side and above and below • Visual fields do decline slightly with age • There are many eye conditions that can affect the visual field • There is a correlation between field of vision and accident rate • Incidence 3-3.5% in 16-60 • Incidence 13% in over 60 • Binoc field loss drivers accident rate twice as high as monoc loss

20. What does this mean? We now have 2 visual parameters that are relevant to driving performance visual acuity affects processing time to react and loss of peripheral visual field makes it easier to miss objects at the edge of vision

21. Where next? • We have an acuity standard and a field standard set by the EC so how is this implemented in the UK? • There is no routine assessment of visual fields • Visual acuity is measured at the driving test by the use of a number plate • Drivers are required to self-assess their vision standard by routinely checking that they can satisfy the number plate test requirement (and self certify after 70 yrs of age)

22. Self Certification

23. What does this show? • Most drivers in the UK have no concept of what the required test distance is for the number plate test • Almost 50% underestimate the required test distance and this would mean that they think their vision is better than it is!

24. Summary • There is no statutory re-assessment of vision in the UK for domestic Group 1 drivers • There is a statutory declaration at age 70 that the number plate test can be met • There is no statutory assessment of visual field at any time in the UK • The only official measure of vision relies on a number plate that will provide a different task depending on the background contrast, the light level, the test distance, the letter combination etc which is carried out at the time of the driving test

25. I hope this brief talk convinces you that • Vision is not treated with the respect it deserves in drivers • A clinical assessment of an individuals vision should be undertaken before they are allowed on the road • Re-evaluation should be undertaken at regular intervals • self assessment currently is inadequate but could provide a gross mechanism for monitoring between re-evaluation • Public awareness of the vision requirements for drivers should be substantially raised

26. Thank You for your attention