6 Visual Disorders - DVLA Assessing Fitness to Drive Guide

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use, so you may find the language more technical than the condition leaflets.
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The 'Assessing fitness to drive: guide for medical professionals' is produced by the Driver and Vehicle Licensing Agency (DLVA) and is a guide for medical professionals to help them with enquiries from the public about driving with various conditions.

Advice for medical professionals for drivers with visual disorders.

X - Must not drive! - May continue to drive subject to medical advice and/or notifying the DVLA√ - May continue to drive and need not notify the DVLA

Minimum eyesight standards – all drivers

The law requires that all licensed drivers to meet the following eyesight requirements (including drivers aided by prescribed glasses or contact lenses):

  • in good daylight, able to read the registration mark fixed to a vehicle registered under current standards
    • at a distance of 20 metres with letters and numbers 79 mm high by 50 mm wide on a car registered since 1 September 2001 or
    • at a distance of 20.5 metres with letters and numbers 79 mm high by 57 mm wide on a car registered before 1 September 2001 and
  • the visual acuity must be at least Snellen 6/12 with both eyes open or in the only eye if monocular

X- Any driver unable to meet these standards must not drive and must notify the DVLA, which will refuse or revoke a licence.

The law also requires all drivers to have a minimum field of vision, as set out below.

Social care registration for a sight impairment or severe sight impairment is not compatible with DVLA driver licensing; such registration is notifiable.

Bioptic telescope devices are not accepted by the DVLA for driving.

Higher standard of visual acuity – bus and lorry drivers

Group 2 bus and lorry drivers require a higher standard of visual acuity in addition:

  • a visual acuity (using corrective contact lenses where needed) of at least:
    • Snellen 6/7.5 (Snellen decimal 0.8) in the better eye and
    • Snellen 6/60 (Snellen decimal 0.1) in the poorer eye
  • if glasses are worn to meet the minimum standards, they should have a corrective power not exceeding +8 dioptres in any meridian of either lens

Minimum standards for field of vision – all drivers

The minimum field of vision for Group 1 driving is defined in the legislation:

A field of at least 120° on the horizontal measured using a target equivalent to the white Goldmann III4e settings.

The extension should be at least 50° left and right.In addition, there should be no significant defect in the binocular field that encroaches within 20° of the fixation above or below the horizontal meridian.

This means that homonymous or bitemporal defects that come close to fixation, whether hemianopic or quadrantanopic, are not usually acceptable for driving.

If the DVLA needs a visual field assessment for determining fitness to drive, it:

  • requires the method to be a binocular Esterman field test
  • may request monocular full field charts in specific conditions
  • exceptionally, may consider a Goldmann perimetry assessment carried out to strict criteria

The Secretary of State's Honorary Medical Advisory Panel for Visual Disorders and Driving advises that, for an Esterman binocular chart to be considered reliable for licensing, the false-positive score must be no more than 20%. When assessing monocular charts and Goldmann perimetry, fixation accuracy will also be considered.

Defect affecting central area only (Esterman within 20 degree radius of fixation)

Only for the purposes of licensing Group 1 car and motorcycle driving:

  • the following are generally regarded as acceptable central loss
    • scattered single missed points
    • a single cluster of up to 3 adjoining points
  • the following are generally regarded as unacceptable ('significant') central loss:
    • a cluster of 4 or more adjoining points that is either wholly or partly within the central 20° area
    • loss consisting of both a single cluster of 3 adjoining missed points up to and including 20° from fixation, and any additional separate missed points within the central 20° area
    • any central loss that is an extension of hemianopia or quadrantanopia of size greater than 3 missed points

Defect affecting the peripheral areas – width assessment

Only for the purposes of licensing Group 1 car and motorcycle driving:

  • the following will be disregarded when assessing the width of field
    • a cluster of up to 3 adjoining missed points, unattached to any other area of defect, lying on or across the horizontal meridian
    • a vertical defect of only single-point width but of any length, unattached to any other area of defect, which touches or cuts through the horizontal meridian

Exceptional cases

Group 1 drivers whose previous full driving entitlement was removed because of a field defect failing to satisfy the standard may be eligible for individual relicensing consideration as exceptional cases under the following strict criteria:

  • defect must have been
    • present for at least 12 months
    • caused by an isolated event or a non-progressive condition
  • there must be no other condition or pathology regarded as progressive and likely to be affecting the visual fields (panel's advice is that certain medical conditions, for example glaucoma and retinitis pigmentosa, would always be considered as progressive and so could not be considered as exceptional cases)
  • sight in both eyes
  • no uncontrolled diplopia
  • no other impairment of visual function, including
    • no glare sensitivity, contrast sensitivity or impairment of twilight vision
  • clinical confirmation of full functional adaptation

For exceptional cases considered to be potentially licensable under these criteria, the DVLA will then require a satisfactory practical driving assessment at an approved centre (see Appendix G).

Static visual field defect

For prospective learner drivers with a static visual field defect, a process is now in place to apply for a provisional licence. Details are on the DVLA website.

Monocular individuals cannot be considered as exceptional cases under the above criteria.

Higher standards of field of vision – bus and lorry drivers

The minimum standard for the field of vision is defined by the legislation for Group 2 bus and lorry licensing as:

  • a measurement of at least 160° on the horizontal plane
  • extensions of at least 70° left and at least 70° right
  • extensions of at least 30° above and at least 30° below the horizontal plane
  • no significant defect within 70° right and 70° left between 30° up and 30° down (it would be acceptable to have a total of up to 3 missed points, which may or may not be contiguous*)
  • no defect is present within a radius of the central 30°
  • no other impairment of visual function, including no glare sensitivity, contrast sensitivity or impairment of twilight vision.

(*Points tested in the 'letterbox' outside the central radius of 30° from fixation.)

For Group 2 bus and lorry driving, it would be acceptable for a defect on visual field charts to have an upper limit of a total of 3 missed points – which may be contiguous – within the letterbox but outside the central 30° radius.

A total of more than 3 missed points, however – even if not contiguous – would not be acceptable for Group 2 driving because of the higher standards required.

Note that no defects of any size within the letterbox are licensable if a contiguous defect outside it means the combination represents more than 3 missed points.

Note Exception 1 in 'Exceptions allowed by older licences' below.

Cataract

Group 1
Car and motorcycle
Group 2
Bus and lorry
! - Often safe to drive and may not need to notify the DVLA.

The minimum standards set out for all drivers above must be met.

Glare may counter an ability to pass the number plate test of the minimum requirements, even when cataracts allow apparently appropriate acuities.

! - Often safe to drive and may not need to notify the DVLA.

The minimum standards for Group 2 drivers set out above must be met.

Glare may counter an ability to pass the number plate test of the minimum requirements, even when cataracts allow apparently appropriate acuities.

Monocular vision

 Group 1
Car and motorcycle
Group 2
Bus and lorry
Including, for any reason, making use of only one eyeX- Must not drive and may need to notify the DVLA. For complete loss of vision in one eye (cases where there is any light perception in the affected eye are not considered monocular), the driver:

♦ must meet the same visual acuity and visual field standards as binocular drivers
♦ may drive only after clinical advice of successful adaptation to the condition

Only those monocular people who fail to meet these requirements are required to notify the DVLA.

X- Must not drive and must notify the DVLA. The law bars licensing if in one eye there is:

♦ complete loss of vision or
♦ corrected acuity falls below Snellen 3/60 (Snellen decimal 0.05)

All Group 2 drivers must at least match the minimum standards for Group 1 visual acuity.

See also 'Grandfather rights' (below).

Exceptions for visual acuity allowed by older licences ('grandfather rights')

The standards for Group 1 car and motorcycle licensing must be met before any of the following exceptions can be afforded to Group 2 bus and lorry drivers holding older licences.

Visual acuity

Exception 1

A driver must have been awarded a Group 2 bus and lorry licence before 1 March 1992, and be able to complete a satisfactory certificate of experience, to be eligible.

If the licence was awarded between 2 March 1992 and 31 December 1996, visual acuity with corrective lenses if needed must be at least 6/9 in the better eye and at least 6/12 in the other eye; uncorrected visual acuity may be worse than 3/60 in one eye only.

Monocularity

Exception 2

Must have been awarded a Group 2 bus and lorry licence before 1 January 1991, with the monocularity declared before this date.

Exception 3

Drivers with a pre-1997 Group 1 licence who are monocular may apply to renew their category C1 (vehicles 3.5t to 7.5t). They must be able to meet the minimum eyesight standards which apply to all drivers and also the higher standard of field of vision for Group 2 (bus and lorry) drivers.

Visual field defects

 Group 1
Car and motorcycle
Group 2
Bus and lorry
Disorders such as:

♦ bilateral glaucoma
♦ bilateral retinopathy
♦ retinitis pigmentosa

and others that produce a field defect, including partial or complete homonymous hemianopia/quadrantanopia or complete bitemporal hemianopia.

! - Must notify the DVLA.

The national recommendations for visual field would need to be met.

See 'Exceptional cases' under the 'Minimum standards for field of vision – all drivers'.

! - Must notify the DVLA

The national recommendations for visual field would need to be met.

Licensing may be awarded if:

♦ horizontal visual field is at least 160°
♦ extension is at least 70° left and right, and 30° up and down
♦ no defects present within a radius of the central 30°

Diplopia

Group 1
Car and motorcycle
Group 2
Bus and lorry
X- Must not drive and must notify the DVLA.

Driving may be licensed after the DVLA has received confirmation that the diplopia is controlled, for example by:

♦ glasses or
♦ a patch for which there is an undertaking to use it while driving (but note the requirements for monocular vision above)

Exceptionally, a stable uncorrected diplopia endured for 6 months or more may be licensable with the support a consultant specialist's report of satisfactory functional adaptation.

X- Must not drive and must notify the DVLA.

Licensing will be refused or revoked permanently in cases of insuperable diplopia.

Patching is not acceptable for licensing.

Night blindness

Group 1
Car and motorcycle
Group 2
Bus and lorry
X- Must not drive and must notify the DVLA.

Driving may be licensed after individual consideration, provided the standards for visual acuity and field above are met.

X-Must not drive and must notify the DVLA.

Driving may be licensed after individual consideration, provided the standards for visual acuity and field above are met.

Colour blindness

Group 1
Car and motorcycle
Group 2
Bus and lorry
√-May drive and need not notify the DVLA.√-May drive and need not notify the DVLA.

Blepharospasm

Group 1
Car and motorcycle
Group 2
Bus and lorry
X- Must not drive and must notify the DVLA.

Driving is not usually licensed if the condition is severe and affects vision, even if treated.

A consultant specialist's opinion will be sought by the DVLA.

Driving may be licensed if the condition is mild, subject to return of satisfactory medical reports.

Control of mild blepharospasm with botulinum toxin may lead to licensing if the treatment does not produce side effects that are otherwise disqualifying, such as uncontrollable diplopia.

The DVLA should be informed of any change – and any deterioration in condition must be notified.

X- Must not drive and must notify the DVLA.

Driving is not usually licensed if the condition is severe and affects vision, even if treated.

A consultant specialist's opinion will be sought by the DVLA.

Driving may be licensed if the condition is mild, subject to return of satisfactory medical reports.

Control of mild blepharospasm with botulinum toxin may lead to licensing if the treatment does not produce side effects that are otherwise disqualifying, such as uncontrollable diplopia.

The DVLA should be informed of any change – and any deterioration in condition must be notified.

© Crown copyright. Reproduced under the terms of the Open Government Licence.

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Author:
DVLA
Peer Reviewer:
DVLA
Document ID:
13236 (v7)
Last Checked:
17 June 2016

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.