title: Glaucoma and driving: Are we documenting driving status and advising patients with glaucoma appropriately about their driving?
abstract: OBJECTIVE
  Guidelines from the Driver and Vehicle Licensing Agency (DVLA) in the UK state that patients with bilateral glaucomatous visual field defects must stop driving unless confirmed able to meet minimum visual field requirements. Guidelines from the Royal College of Ophthalmologists state that ophthalmologists must consider driving status in every consultation, provide appropriate information if visual problems may affect driving and document any advice that has been given. The authors aimed to investigate whether in glaucoma clinics: (1) driving status is being documented, (2) appropriate patients have been advised to inform DVLA and (3) there is documentation that this advice was provided.
  
  
  METHODS
  A prospective, observational study of 133 patients presenting to subspecialty glaucoma clinics in two hospitals between December 2014 and March 2015. Patients were interviewed and had their electronic medical records examined at the time of consultation.
  
  
  RESULTS
  Of 133 patients, 50.4% (67/133) had previous documentation of driving status. A total of 88 patients were drivers, and 54 of these drivers had a diagnosis of glaucoma. Twenty-four patients were drivers with bilateral glaucomatous visual field defects, thus meeting the criteria that necessitate informing the DVLA. Of these patients, 45.8% (11/24) had documentation of driving status, 54.2% (13/24) had been advised to inform DVLA, and 4.2% (1/24) had documentation that this advice was provided.
  
  
  CONCLUSIONS
  We found there was a lack in documentation of patients' driving status and advice given to patients. If our results represent the general trend in eye clinics, we must develop a more robust process to improve this.
authors.affiliation: Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK.
authors.forename: Amun
authors.initials: A
authors.lastname: Sachdev
authors.affiliation: Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK.
authors.forename: Mazen
authors.initials: M
authors.lastname: Tahhan
authors.affiliation: Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK. velota.sung@nhs.net.
authors.forename: Velota Ching Tak
authors.initials: VCT
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000331:legislation & jurisprudence*; D005260:Female; D005901:Glaucoma; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011446:Prospective Studies; D006113:United Kingdom; D015354:Vision, Low; D055815:Young Adult
keywords: DVLA; Documentation; Driving; Glaucoma; Visual fields