Patients and their families are often concerned about driving when diagnosed with or while suffering from age-related macular degeneration. While driving isn’t always out of the question, the patient’s visual function, desire for independence, and requirement for safety must all be evaluated on a regular basis. Many people can still drive safely and lawfully if they meet the legal criteria. If your eye specialist tells you that you have a vision problem in both eyes that can’t be cured with prescription glasses, you have a legal obligation to notify the driving license authorities in your country. You may be breaking the law if you don’t.
Evaluating your Vision
In its initial stages, AMD causes blurry or cloudy vision and dark “blind” spots in the central visual field. During this early stage, reading road signs and driving at night or in certain weather conditions may be challenging. People with Age-Related Macular Degeneration generally find it easier to drive during the day than at night, and may “self-restrict” their driving to daytime on known roads in good weather.
As the disease progresses, the blind spots will grow larger, and eventually lead to a total loss of central vision. As a result, your ability to drive safely may no longer be possible.
Safe driving is all about reading the road in order to best evaluate situations quickly and early to prevent accidents. The fact that drivers with AMD are not as adept at evaluating situations and responding as quickly, means that they pose a potential safety concern on the road.
In Ireland the NDLS need to be informed if you have been diagnosed with any condition likely to cause progressive loss of vision. This includes, but is not limited to, macular degeneration, glaucoma, retinitis pigmentosa, and diabetic retinopathy.
You should include this information on your driving licence application form (D401). Your doctor or optometrist will include it on the medical report that you need to renew your licence (D501).
Forms for the Medical Report for a Driver’s License and the Eyesight Report for a Driver’s License can be downloaded by clicking here. If you have any changes in your eye health/vision it is vital to check the rules and regulations in your country regarding driving.
Vision Tests
A Visual Acuity test determines how clear your eyesight is. Binocular visual acuity of at least 6/12 is required to drive a private car or motorbike. This indicates that you can see at 6 metres what a person with normal vision can see at 12 metres when you use both eyes simultaneously, with glasses or contact lenses if necessary.
There’s more to this problem than visual acuity, which only assesses the operation of a small portion of the macula. Parts of the macula in people with Age-Related Macular Degeneration may stop working, resulting in distorted vision or a blind spot in part of the visual field. Even without moving our eyes or heads, we have an uninterrupted visual field of around 180 degrees horizontally when both eyes are operating normally. Our peripheral retinas give critical information about other cars and pedestrians, while our macula provides the high acuity vision required to read street signs. Since these retinal cells are extremely sensitive to motion, we can notice a moving item faster than a stationary one.
A Visual Field Test determines this important peripheral vision to ensure that you have enough peripheral field vision to see objects on the road coming from the sides. And also to ensure you do not have any blind spot defects in the centre of your vision that would be deemed dangerous..
The Number Plate test is a quick test you can do yourself and will test if you can see a normal car number plate from a distance of 20 meters in excellent daylight while using your prescription glasses. Try it by stepping 25 paces away from a parked car– one you don’t recognise – and see if you can read the license plate. This is simply a guide and does not imply that your vision fulfils the minimum requirements for driving.
What Happens if I Fail the Tests?
The driving authority will assess whether it is safe for you to drive based on the results.
You cannot drive on a public road if you do not meet the required standard. If you do, you will be committing a serious crime. It’s also possible that you’ll lose your insurance coverage.
Your vision will be examined every 12 to 24 months if you have a degenerative condition like macular degeneration. Consult your GP, optician, or eye specialist if you believe your vision has deteriorated and you’re not sure if it’s harming your ability to drive.
Thinking Ahead
It’s best to take control and plan ahead if you think you’ll need to quit driving in the future. Check out local transport in your area. For example bus and trains, are a nice way to travel if you no longer can drive safely. They also take the stress out of finding a parking space and offer a social outlet as you may meet people you would have not if you drove alone!
If you’re ever unsure whether your vision is good enough to drive, consult an optician or an ophthalmologist. One way of keeping track of your vision is attending annual eye tests. It is better to play it safe rather than risk injuring yourself or others. Ask yourself…”Would I be able to see that child chasing the ball across the street?”
One simple way of keeping Age-Related Macular Degeneration at bay or from getting progressively worse is to boost your diet with the three critical macular carotenoids – Lutein, Meso-Zeaxanthin and Zeaxanthin.
