In 2018, John Snelgrove, a Hertfordshire based dispensing optician, wrote to the Driver and Vehicle Licensing Agency (DVLA) asking it to recommend eye care professionals inform all drivers whether their eyesight is legally good enough to drive.
Snelgrove decided to send the letter in the first place due to a ‘number of people who are driving at any age who cannot read the number plate at the 20-metre distance.’ He said: ‘This is contributing to accidents and the current DVLA requirement of self-certification until age 70 is not sufficient in my opinion.’
Currently, the only legal eye test drivers are required to take is during their practical driving test, where they have to be able to read a car’s licence plate from 20 metres away before they can proceed with the rest of the test.
Paul Murphy, who works in medical licensing policy at the DVLA, said in his reply to Snelgrove that ‘there is little evidence to suggest that introducing a stricter regime to include mandatory testing or medical examinations would improve road safety. The Government’s view is that it is more effective to raise public awareness of the importance of regular eyesight tests than to introduce mandatory testing and fully supports the NHS’s recommendation that adults should have their eyes tested every two years.’
Snelgrove disagreed with this response and believed that mandatory testing would benefit drivers. He said: ‘It’s obvious from the number of people who we have to advise to wear spectacles to meet the 6/12 standard for driving. In fact, a delivery driver came in to my opticians and was reading his palm device very easily. He was obviously over 50, so I asked him to look at the three metres test chart I have on the wall and he could only see 6/24. So, I gave him a pair of my pinhole specs to try and he could then see 6/6. He did not know his eyesight was not legal to drive.’
Snelgrove has also been campaigning for insurance companies to legally require anyone buying a policy to provide them with a certified letter from an optician saying that they can legally drive. He suggested that companies could provide a financial incentive for customers who do this as well as sending out pinhole cards and test charts, so people are able to perform a rudimentary sight test on themselves. This entails people wearing glasses made of either plastic or card with tiny holes in the lens area, which allows vision to focus on something in the distance but makes it dimmer. If worn either with or without vision aids but not while driving, this indicates if your vision is good enough to drive or if you need to visit an opticians practice for a full eye examination to see if you need glasses.
Medical fitness to drive
The 2017 European Commission Study on Driver Training, Testing and Medical Fitness which was highlighted in the DVLA’s reply looked at ‘improving the education and training of road users in Europe through a range of training, testing and licensing approaches and the protection of vulnerable road users, especially motorcyclists and also older drivers.’ Evidence of effectiveness for different approaches to training, testing, risk for car drivers and requirements on medical fitness to drive, particularly for older drivers among others were reviewed as part of the study.
How clear is clear enough for driving?
In the requirements on medical fitness to drive section of the study, it was acknowledged that GPs often do not want to restrict mobility for older people by informing the DVLA about their inadequate eyesight due to the major negative impact that it can have on health and wellbeing. The study suggested ‘age-based screening isn’t effective, the frequency with which older drivers need to renew their licence is variable and, along with age limits, is not based on current best practice regarding crash risk or incidence of relevant disease.’ It further suggested that the use of screening tools is generally shown not to reduce crashes.
Snelgrove commented that he does not think opticians are aware of the EU study as he had never seen this before. He said: ‘Having read the report based on the EU findings, there is no mention of any study having been done with regard to wearing correct spectacles or contact lenses and the effect it has on driving. The report appears to be only considering elderly drivers and the effect of them becoming immobile rather than the need to consider all age groups with a better method of eye examination including visual fields.’
Overall, the 2017 European Commission Study on Driver Training, Testing and Medical Fitness found that age-based mandatory assessment programmes that have specifically targeted older drivers are unlikely to produce safety benefits.
While many drivers can and do self-regulate their vision, the research has also identified some older drivers who do not self-regulate to an appropriate level. Research has found that older drivers have a low level of avoidance of difficult driving situations. Drivers aged over 64 years who had been involved in a crash in the previous year and who had impaired visual abilities were interviewed and it was discovered that three-quarters of the participants reported never or rarely avoiding difficult driving situations, despite many believing that impaired vision does affect driving ability and that impairments would be noticeable. Most of the participants also rated their vision as excellent or good and reported no difficulty with driving in challenging situations, suggesting that the participants were not aware of their visual impairments and were not self-regulating their driving to compensate for them.
Snelgrove (pictured) does not think opticians are happy with the fact a GP has to inform the DVLA if a patient no longer has adequate vision for driving and is of the opinion that opticians should be able to do this. He said: ‘Opticians are not obliged to refer someone to the patients’ GP and optometrists are the primary source of reporting eyesight issues to the patient. For example, a patient came in to see me and drove to my practice. We informed him that he should not be driving due to his poor eyesight. He asked if we had to refer him to his GP and we said no, so he asked us not to do it and drove away. So, the GP will only have the qualified knowledge of someone’s eyesight if the GP checks their eyesight or is sent a letter from an ophthalmologist.’Last year, the Government published its response to the Cycling and Walking Investment Strategy Safety Review, which included a 50-point action plan for the next two years. This will see the DVLA encourage drivers to check their eyesight regularly and consider the needs of vulnerable road users, which includes older drivers and those with vision problems. The DVLA said: ‘eyesight and driving is one of a number of areas that the department will keep under review.’
The Strategy Safety Review said that the Government will engage with motor insurers and with organisations that promote best practice in work-related road safety management and whether there is scope for insurance companies to provide incentives for drivers to undertake training focused on the needs of vulnerable road users.