Automobile drivers with retinal diseases - a prospective analysis

Background: The study was designed to prospectively evaluate the driving ha bits of patients with retinal diseases, who were referred to the specialise d retinal ambulatory care center of the Landesaugenklinik Salzburg. The mai n purpose of this study was to compare the legal requirements for visual ac uity, as currently valid in Austria and Germany for driving motor vehicles, with the results found in this patients cohort and to analyse driving patt erns of the patients with valid licenses. With these data, it seems possibl e to suggest a suitable time for a legally mandatory eye examination as to identify subjects with a potentially rising higher accident risk when drivi ng. Materials and methods: in this study, 100 patients - all holders of a valid driving licence - with diabetic retinopathy or age related macular degener ation were enrolled. From each patient, the visual acuity (corrected or unc orrected depending on the driving habit) was recorded and a detailed questi onnaire regarding the actual driving habits was requested. The resulting da ta were analysed in view of the legal requirements of both countries, Austr ia and Germany. Results: Of 100 patients holding a valid driving licence a total of 31 were driving their motor vehicles with a legally insufficient visual acuity, 26 of 50 still driving. Of 50 patients suffering from diabetic retinopathy, 2 6 drove their cars illegally. Only 4 out of the above mentioned 31 patients had received sufficient information from their referring ophthalmologists. The average age of "illegal" drivers was 66.2 years. Conclusions: Within the European Community common legal requirements for dr iving a motor vehicle (regarding mainly the visual acuity) be clearly defin ed and a mandatory eye exam performed by qualified ophthalmologists for old er subjects should be postulated. An individual and age related time limit to be placed on the driving licences of persons suffering from systemic dis eases associated with relevant visual loss should to be discussed. Furtherm ore, ophthalmologists should be obliged to give detailed information to the patient with adequate documentation.