All Posts Tagged Tag: ‘Driving Sight Test’

Driving Vision and Glaucoma

A still from a video simulating driving with Glaucoma

Yesterday was the annual AGM of the Association of Optometrists, and also a study day- all Optometrists have to undertake a certain amount of Continuous Education and Training. At the moment this is voluntary, but will probably become compulsory in due course.

One of the lectures at the study day was about driving and vision, a subject that has become very topical of late. Particularly interesting I thought were a couple of videos which tracked the eye movements of Glaucoma patients when tested in a Hazard Perception Test. It had always been assumed that people who have a visual field deficiency will scan around, and move their head more to compensate for their problem, but as is mentioned here, the issue is that they may not even realise that they have a problem, and even if they are aware of an issue, they do not see the problem. If you don’t see something, you don’t think “I didn’t see that” – you just don’t see it.

The Hazard Perception test used eye tracking to follow the “Point of Regard” of normals and Glaucoma patients, also measured were reaction times – when would they hit the brakes?  The study found that people with Glaucoma do not scan around more than normals – indeed one of the videos below show that they remain fixed almost exclusively on the car ahead, failing to notice the hazard of a car pulling out ahead, until the car they are following reacts to the threat.

Video Number 2 shows the Glaucoma patient’s Point of Regard in Blue, the normals are shown in red, it is quite noticeable how little the Glaucoma patient looks at other aspects of the driving scene – they completley fail to look at the pedestrian with the buggy, something all the normals are obviously worried about.

Video number 3 has superimposed onto it a representation of the patients field of vision-  the more dense the areas of field loss, the darker the overlay. (It moves around because its position is relative to the fixation point, the blue dot. Remember that a Glaucoma patient will not see this blackness, they will just have blank areas, their brain will fill in the details as best it can.

The Glaucoma losses featured in Video 2 and 3 are mild to moderate – according to UK standards (where this study was done), this patient would still be legal to drive.

This shows that even if you do not feel that you have a problem, you should have your eyes regularly checked!

 

The full articles are available to read at these two links;

Obstacle Avoidance, Visual Detection Performance, and Eye-Scanning Behavior of Glaucoma Patients in a Driving Simulator: A Preliminary Study

Exploring Eye Movements in Patients with Glaucoma When Viewing a Driving Scene

Driving Sight Tests AGAIN

RSA Logo

rsa-logoThe RSA has now issued its guidance on their latest  requirements  for eye testing for licencing purposes, and they have basically reverted to the old standards, at least for young people who only require a Class 1 (Standard non-commercial) licence

The Road Safety Authority wrote to us in December 2010, advising us of new standards for driving sight tests. There were many issues with their new standards which meant that there had to be a long consultation process, but this now seems to have been resolved.

For the last two years, optometrists have done their best to conduct the driving sight tests as close to the RSA’s requirements as possible. In contrast many GPs, following their own professional body’s advice, continued to conduct the driving sight tests to the older standards.

Where there is any reason to doubt a person’s fitness to drive, due to age, cataracts, glaucoma or any other known condition, more tests will probably still need to be done.

At least for the young, this means that driving sight test will be less expensive, as they are much quicker to complete than before.

Driving Sight Tests

RSA Logo

In late December the RSA wrote to all “stakeholders” regarding the new standards required for driver’s vision. These new tests have been hurriedly implemented, and apparently without enough though put in to which tests would be recommended or acceptable, and what would be the pass mark! Optometrists, as recommended by our Association have implemented these new standards, as far as possible at least, until further clarification allows the full testing to be done.

Some GPs, as recommended by their professional body, The Irish College of General Practitioners, continue to perform the driving sight test to the older standards. The main issue to us is that the new standards involve a full eye examination plus further testing, which is obviously time consuming to check, and therefore more expensive for our clients than the old test. We are obliged to do the new tests this way- we are bound to do what is recommended as best practice by our professional body- the Association of Optometrists.

Driving Sight Tests

RSA Logo

D502 Driving Sight Test

In late December 2010 the RSA wrote to us informing us of new standards to which applicants had to be tested. These new standards were introduced November 1st, but they were willing to accept old standards until 1st February 2011.

The new standards require a full eye examination plus central and peripheral visual fields, for which we charge more than a standard eye exam. There are some more tests which were introduced, but have been postponed until the RSA can advise us of the required pass marks for the relevant tests.

However, The Irish College of GPs have interpreted the new standards in a different way to the Association of Optometrists- the ICGP are advising their GP members that if the candidate passes the Visual Acuity test- the old test, and there is no reason to suspect any other problem, then that is all they need to do.

From ICGP’s clarification document- “Thus having tested visual acuity if the doctor is happy with the result and has no other reason for concern re vision there is no need to proceed to or arrange testing for twilight vision etc.”

As members of the Association of Optometrists we are bound to take the advice and guidance of our Association, and therefore cannot continue to provide the old Driving Sight Test, as GPs seem to be doing. Indeed, the Association of Optometrists has written to the RSA regarding the GP’s interpretation of the standards, but as yet has not had a response.

As can been clearly read in the pdf form D502 – EYESIGHT STANDARDS – The examination shall cover the following: visual acuity, field of vision, twilight vision, glare and contrast sensitivity, diplopia and other visual functions that can compromise safe driving.

The whole situation is unfortunate- the RSA has had approximately 3 years to put these new standards into place, and their implementation has been at best rather tardy.

If you notice a large discrepancy between what Optometrists and GPs are charging for a Driving Sight Test, this is the reason- for the meantime you can choose to have the test done wherever you can, but in the longer term it seems that because most GPs do not have the necessary equipment, they may be unable to continue to offer these tests, if and when the RSA clarifies its position.

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