www.diabeticretinopathy.org.uk

Driving with retinopathy

David Kinshuck

 

Mild retinopathy

Driving is safe with background retinopathy. There may be a little glare as below

 

Hypos

Remember that control of your diabetes is important, and this may mean you are more liable to hypos. Learn how to prevent these and to treat them when they develop. You must be aware of hypos to maintain a driving licence. Frequent hypos mean you legally must stop driving (p 27).   Legally you have to stop driving after one serious hypo, and have to reapply for a licence.

 

Visual Acuity & DVLA

You have to be able to read a number plate at 20m (new number plate) 20.5 (old). This is equivalent to reading the 6/12 snellen line in the eye clinic at 5m, with both eyes (equivalent to 6/10) BJO 15. Here is the  DVLA website. You must notify the DVLA if you have laser treatment of both eyes, or if you have laser to your one good eye.

 

Glare

This includes maculopathy and pre-proliferative and proliferative retinopathy. Several problems arise:   

healthy retina, no reflection, no glare

Healthy retina, no glare: light absorbed

lasered retina, lots of reflection, lots of glare

Damaged retina, glare: light scattered and reflected

 

 

Some people have to stop driving at night, and are unable to drive if the sun is shining directly into their eyes: tinted glasses or sunglasses may be helpful.

 

Severe glare

With the more severe types of retinopathy and particularly after you have needed a lot of laser glare may be a really severe problem. Try sunglasses, consult your optometrist and ophthalmologist, but if extremely severe you may have to give up driving.

 

glare from car headlights

glare from car headlights

glare from the sun

glare from sunlight

 

 

 

 

Field loss

Retinal damage both from the retinopathy and laser can result in parts of your sight being missing:

 

small filed defect, safe for driving
Minor peripheral field loss, probably legal to drive
part of visual field missing, unsafe for driving (visual field defect)
Severe central field loss: unsafe and illegal driving

 

There should not be a significant visual field defect. This is described in more detail here. There must be no defect greater than 3 adjacent missing points on the the Esterman field. There are exceptions if the condition is completely stable, such as burnt out retinopathy, but each 'exceptional' case has to be discussed with the DVLA.

If you have active retinopathy you will no be able to drive if you have more than 3 joined up points missing on the Esterman field, because it would not be safe. Driving and laser techniques for professionals see p126.

 

Licence for 1 year or 3 years

If your condition is stable or deteriorating slowly, you may be entitled to a 3 year licence. But if your condition is getting worse and you are having laser, you may only get a 1 year licence.

 

Poor night vision

After lots of laser for diabetic retinopathy, you may notice a lot of glare and poor night vision. Many such people can see safely during the day, but have poor night vision. These patients are often legally allowed to drive as above, but are not safe to drive at night.

This applies to many of my patients...such a patient must not drive if they see poorly, so they would not drive in bad weather, looking into the sun, heavy rain, or in fog. Because they see well in daylight they are safe to drive in daylight.

 

Slow reactions

Patients who have laser have microvascular disease, and this often affects brain function. Such patients should avoid driving fast, and some need to drive on roads they are familiar with, and not on roads they do not know.

 

Link

see

 

Professionals

Driving field assessment 

Exceptionality, eg hemianopia