title: Are Eye Clinics Safe For The Road? An Observational Report.
abstract: We report an observational study, based on the examination of 319 medical records, identifying the proportion of patients whose driving status was documented on the first and subsequent glaucoma clinic visits. We also established the proportion of patients with documented Driving and Vehicle Licencing Agency (DVLA)-related advice when they did not meet driving standards based on their visual acuity and/or visual fields (VF). On presentation, driving status was assessed in 61% (n=195) patients. Of the remaining 124, 44% (n=55) had their driving status documented at a subsequent visit, on an average 8 years later. Of all patients (78%, n=250) whose driving status was assessed at some stage, 42% (n=134) were drivers. Of the 203 patients who were either drivers or whose driving status was unknown, 37% (n=75) were assessed as having a visual acuity or bilateral VF defect that was below the legal limit for driving, 39 of whom were known drivers. Only 13 were advised to inform the DVLA, and only 5 patients were advised to update their spectacles or listed for surgery to improve their vision. We therefore potentially failed to perform our DVLA duty in 76% (n=57) of patients. We have made suggestions for improving the current performance in this respect based on the findings of this study.
authors.affiliation: *Glaucoma Department, Moorfields Eye Hospital NHS Foundation Trust †Institute of Ophthalmology, EIEH, London, UK.
authors.forename: Esther
authors.initials: E
authors.lastname: Papamichael
authors.forename: Rashmi
authors.initials: R
authors.lastname: Mathew
authors.forename: Deborah
authors.initials: D
authors.lastname: Kamal
authors.forename: Ian E
authors.initials: IE
authors.lastname: Murdoch
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001333:Automobile Driver Examination / Q000331:legislation & jurisprudence*; D001334:Automobile Driving / Q000592:standards*; D005260:Female; D005901:Glaucoma / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000592:standards*; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D015351:Vision Screening / Q000592:standards; D014792:Visual Acuity / Q000502:physiology*; D014794:Visual Fields / Q000502:physiology*