Abstract
Purpose/background Following laser panretinal photocoagulation (PRP) for proliferative diabetic retinopathy, patients are at risk of failing the UK driving visual field test due to loss of peripheral field. Although a definition of the minimum field requirement exists, differences in its interpretation may influence whether fields pass or fail. Currently it is not known how fields are interpreted in practice nor to what extent this affects failure rates.
Methods Uniocular and binocular Esterman visual fields from 60 diabetic patients following PRP were examined both by the chairman of the Visual Standards Sub-Committee of the Royal College of Ophthalmologists and separately by four consultant ophthalmologists. The results were analysed (1) to assess the extent of agreement and (2) to identify, from the chairman's results, the field deficits that are still compatible with passing.
Results Agreement was generally good for binocular fields but was only moderate for uniocular fields. In up to 15% of binocular fields and 43% of uniocular fields the chairman's decision was different from that of the consultants. Several key aspects of the field that influence a pass/fail decision are identified.
Conclusions Substantial differences in the assessment of driving visual fields following RPR currently exist between consultants and the chairman of the Visual Standards Sub-Committee. Using the information presented here to guide assessment it is now possible to reduce this variation.
Similar content being viewed by others
Article PDF
References
Williamson TH, George N, Flanagan DW, Norris V, Blamires T . Driving standards visual fields in diabetic patients after panretinal laser photocoagulation. Vision in vehicles III. Amsterdam: North-Holland, 1991:265–72.
Hulbert MFG, Vernon SA . Passing the DVLC field regulations following bilateral pan-retinal photocoagulation in diabetics. Eye 1992;6:456–60.
Buckley SA, Jenkins L, Benjamin L . Fields, DVLC and panretinal photocoagulation. Eye 1992;6:623–5.
Mackie SW, Webb LA, Hutchison BM, Hammer HM, Barrie T, Walsh G . How much blame can be placed on laser photocoagulation for failure to attain driving standards? Eye 1995;9:517–25.
Pearson AR, Tanner V, Keightley SJ, Casswell AG . What effect does laser photocoagulation have on driving visual fields in diabetics? Eye 1998;12:6–8.
At a glance guide to the current medical standards of fitness to drive. Drivers Medical Group. Bristol: DVLA, March 1996.
Definition of the minimum field of vision for safe driving for Group 1 ordinary drivers. London: Royal College of Ophthalmologists, 1994.
Keightley SJ . Personal communication. Sept 1995.
Drasdo N, Haggerty CM . A comparison of the British number plate and Snellen vision tests for car drivers. Ophthalmol Physiol Opt 1981;1:39–54.
Esterman B . Functional scoring of binocular fields. Ophthalmology 1982;89:1226–34.
Brenman P, Silman A . Statistical methods for assessing observer variability in clinical measures. BMJ 1992;304:1491–4.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pearson, A., Keightley, S. & Casswell, A. How good are we at assessing driving visual fields in diabetics?. Eye 12, 938–942 (1998). https://doi.org/10.1038/eye.1998.243
Issue Date:
DOI: https://doi.org/10.1038/eye.1998.243
Keywords
This article is cited by
-
Effect of calcium dobesilate on retrobulbar blood flow and choroidal thickness in patients with non-proliferative diabetic retinopathy
International Ophthalmology (2021)
-
Effect of calcium dobesilate on progression of early diabetic retinopathy: a randomised double-blind study
Graefe's Archive for Clinical and Experimental Ophthalmology (2006)
-
Letter
Eye (2000)