National application of the European visual field standards for driving: a survey study

BMJ Open Ophthalmology

article

Thea Melsen Sudmann¹  Thora Elisabet Jonsdottir²  Fiona J Rowe³  Øystein Kalsnes Jørstad² 

[1] Department of Ophthalmology , Hospital of Southern Norway;Department of Ophthalmology , Oslo University Hospital;Faculty of Health and Life Sciences , University of Liverpool;Faculty of Medicine , University of Oslo

关键词: diagnostic tests/investigation;    field of vision;   

DOI  :  10.1136/bmjophth-2021-000904

学科分类：工业工程学

来源: BMJ Publishing Group

【 摘 要 】

Aims To provide an overview of how the European visual field standards for driving (specified in Commission Directive 2009/113/EC) are applied and determine whether individuals with visual field defects are treated equally across Europe.Methods One ophthalmic expert from each of 32 European countries was invited to participate in an electronic survey. They were presented with threshold and Esterman perimetry results of 15 cases of visual field defects and asked to classify each case as either passed or failed in reference to their national standards. The results were compared with the European Driving Test Group 1 (EDT1), which is a new perimetry algorithm that adheres to the recommendations by the Eyesight Working Group. Fleiss’ kappa was used to determine the inter-rater agreement.Results Twenty-five countries responded. Three of 15 cases were passed by all. Full agreement on a failed case was not reached. Denmark graded most leniently and passed 12 cases. Bulgaria, Romania and Slovakia graded most strictly and passed five cases. The Fleiss’ kappa score was 0.52 (95% CI 0.49 to 0.55). Only Slovenia was in full agreement with the EDT1. Fifteen countries endorsed specific perimetric tests for assessing fitness to drive. Five of these also defined pass/fail criteria.Conclusion The directive fails to establish a uniform approach to the visual field requirements, as evident by moderate pass/fail agreement between the national experts. Because the visual standards for driving are enforced differently, identical visual field loss can result in either revocation or approval of a driving license.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND