01Role and principlesWho benefits and the main preventive aims.
Visual acuity describes resolution under the conditions of the test; driving also depends on usable visual field, single vision and function under changing illumination. A person who reads a chart in a bright clinic may still have substantial glare, contrast or night-vision difficulty. The consultation should therefore identify the actual licence group and symptoms before interpreting a number as reassurance.
Clinical advice, licensing and employment assessment have related but distinct purposes. DVLA and DVA make licensing decisions; clinicians provide accurate evidence and immediate safety advice. Employers and occupational-health services assess work tasks and possible adjustments, sometimes under additional sector-specific standards. Failure to meet a driving requirement does not establish inability to perform every job, and the ability to drive a car does not certify someone for every professional role.
Key points
- Great Britain uses DVLA; Northern Ireland uses DVA and its published instructions.
- Group 1 requires the number-plate test, at least 6/12 acuity and the applicable field standard.
- Group 2 normally requires at least 6/7.5 in the better eye and 6/60 in the poorer eye.
- The Group 2 spectacle limit is +8 dioptres, not an absolute limit on minus-powered lenses.
- Diplopia has specific notification and return-to-driving requirements beyond a reading-chart result.
- Monocular adaptation is a clinical issue, and Group 1 and Group 2 rules differ.
- Colour blindness alone does not require DVLA notification, although a particular job may have separate colour requirements.
- Workplace capability depends on tasks, risk controls and reasonable adjustments as well as eye measurements.
02Assessment and patient selectionRisk features, eligibility and important cautions.
Ask where the licence was issued and which vehicle categories the person uses, including occupational driving. Do not assume that someone who drives for work necessarily has a Group 2 licence, or that a car licence covers a bus-driving question. Older licence exceptions require checking against the actual entitlement history.
Record acuity in each eye and binocularly, noting glasses or contact lenses and the conditions of testing. If prescribed correction is needed to meet driving standards, it must be worn while driving. A patient who passes with glasses but routinely leaves them at home has an implementation problem requiring clear advice.
Enquire about glare from headlights, trouble in dim light, missed objects at the side and diplopia. Cataract can produce troublesome glare despite apparently satisfactory acuity. The history may reveal a reason for further assessment even when the initial chart result meets a numerical threshold.
Clarify whether the person reads screens, inspects small parts, judges colour signals, drives, works at height or uses moving machinery. Include lighting, working distance and time pressure. Occupational-health advice should connect a specific functional limitation to a specific task and possible modification.
A new loss of binocular function may alter depth judgement, scanning and confidence. After loss of vision in one eye, Group 1 return requires clinical advice that adaptation is successful and the remaining visual requirements are met. Do not substitute an invented fixed waiting period for this assessment.
03Baseline assessmentMeasurements that guide the plan and track progress.
Read from the initial assessment onwards. Tests may run in parallel in urgent care; first-line, preferred, confirmatory, definitive and gold-standard labels appear only when the chapter explicitly states them.
- 01
Snellen acuity and practical number-plate requirementFirst step - Why
- Assess the applicable legal acuity requirements with correction where needed.
- Interpretation and limitations
- For Group 1, at least 6/12 with both eyes open or the only seeing eye is required alongside reading a current-standard registration plate in good daylight at 20 metres. Older plate dimensions have a 20.5-metre distance. Meeting one requirement does not cancel the other.
- 02
Group 2 monocular acuities and correction details - Why
- Determine whether the higher bus and lorry requirements are met.
- Interpretation and limitations
- The usual acuities are at least 6/7.5 in the better eye and 6/60 in the poorer eye. If spectacles provide the correction, plus power must not exceed +8 dioptres in any meridian of either lens. Contact lenses have no corresponding specific power limit; other standards still apply.
- 03
Visual field assessment - Why
- Investigate field loss with the method required for the licensing question.
- Interpretation and limitations
- DVLA Group 1 requires at least 120° horizontally, extending at least 50° left and right, without a significant binocular defect encroaching within 20° of fixation above or below the horizontal. Group 2 requires uninterrupted horizontal width at least 160°, extending at least 70° left and right and 30° above and below, with no defect within the central 30° radius. Apply the additional peripheral-field criteria in the current guidance. Confrontation cannot replace formal licensing perimetry; DVLA normally requires binocular Esterman testing.
- 04
Orthoptic or ophthalmic diplopia assessment - Why
- Establish the cause, stability and effectiveness of treatment for double vision.
- Interpretation and limitations
- Under DVLA guidance, both groups must stop driving and notify. Group 1 resumption requires the specified confirmation of control; patching also invokes monocular requirements. Patching is not accepted for Group 2 licensing, so the same treatment has different licensing consequences.
- 05
Workstation and task assessment - Why
- Identify practical adjustments and any job-specific visual requirements.
- Interpretation and limitations
- Review equipment, display distance, contrast, lighting and hazards with the worker and relevant service. HSE advises reviewing the existing workplace risk assessment when disability becomes relevant; there is not a universal legal requirement for a separate disability-specific assessment.
04InterventionsLifestyle, treatment and escalation options.
01Driving assessmentTurn the findings into clear immediate adviceFirst stepAn eye condition or its treatment may affect the person's ability to drive safely.+
- 1Identify the licence group and responsible agency, then assess the relevant acuity, field and functional issues.
- 2Explain whether driving must stop and whether notification is required under the condition-specific guidance.
- 3Arrange the necessary eye investigations or treatment, recording the correction used and uncertainties that remain.
- 4Give written advice and practical transport options, with a clear plan for reassessment rather than an unsupported promise of relicensing.
02Potentially correctable problemVerify function after treatment or correctionRefraction, cataract treatment or diplopia control may improve the patient's driving vision.+
- 1Address the underlying ocular problem while maintaining any current driving restriction.
- 2Reassess the applicable visual measures and symptoms using the correction or treatment that will actually be used.
- 3For diplopia, follow the licensing requirements for confirmation of control rather than allowing immediate return based on subjective improvement.
- 4Seek agency or specialist advice when an older-licence exception or an unusual visual pattern may apply.
03Work participationAssess the job and organise appropriate adjustmentsSight impairment affects employment, training or a safety-critical task.+
- 1Describe the visual limitation in functional terms and obtain the worker's account of tasks that are difficult.
- 2Involve occupational health and the employer through appropriate consent and information-sharing arrangements.
- 3AlternativeReview practical controls such as lighting, magnification, screen settings, alternative tasks and safe travel.
- 4Check sector-specific standards where relevant and arrange review after adjustments or treatment, avoiding an undifferentiated verdict about all work.
05Targets, monitoring and follow-upResponse, safety and longer-term review.
- Review driving advice when vision, diplopia control, treatment or licence category changes rather than assuming a previous assessment remains sufficient.
- Record the reason for any restriction, agency notification advice and the agreed route back to assessment.
- Follow up whether prescribed visual correction and workplace adjustments are available and being used effectively.
- For progressive eye disease, retain the eye-service surveillance plan and explain that meeting standards today does not guarantee future eligibility.
- If a patient continues unsafe driving, make every reasonable effort to persuade them to stop. Where continued driving exposes others to death or serious harm, the GMC advises prompt confidential disclosure of relevant information to the DVLA or DVA medical adviser. Try to explain the intended disclosure first, consider objections, then confirm any disclosure to the patient in writing and document it.
06Special situationsVariants, exceptions and circumstances that change the usual approach.
Plus power has a sign
The Group 2 spectacle criterion limits positive corrective power. Rewriting it as a limit on the magnitude of any lens power incorrectly excludes some people using strong minus lenses. Acuity, fields and the rest of the assessment still need to be satisfactory.
Monocular rules need careful wording
DVLA permits qualifying Group 1 drivers to return after successful adaptation and achievement of acuity and field requirements. Those meeting the monocular requirements do not have to notify solely for complete monocular loss. Group 2 restrictions are much stricter, with limited older-licence provisions that need individual checking.
Screen work and eyesight provision
For qualifying DSE users in Great Britain, HSE states that employers must arrange and pay for an eye and eyesight test when requested. They pay for glasses required specifically for the screen-viewing distance, not ordinary spectacles that already provide suitable correction. Screen symptoms still deserve an ordinary clinical assessment when appropriate.
Adjustments and additional support
Reasonable adjustments are an employer responsibility. Access to Work may provide eligible additional support, but its current guidance says it does not pay for the reasonable adjustments the employer must make. Discuss the actual need and route rather than promising a particular award or amount.
Colour testing serves different questions
Colour blindness alone is compatible with DVLA Group 1 and Group 2 driving without notification. A workplace relying on specific colour signals may need a different, job-related assessment. Do not impose a blanket employment restriction from an incidental colour-plate result.
Group 2 peripheral-field limits
Outside the central 30° radius but within 70° left and right and 30° above and below, DVLA permits at most three missed points. A contiguous defect extending outside this region also counts when the combined defect exceeds three points. Glare, contrast and twilight impairment require separate consideration.
07Common pitfallsFrequent interpretation and management errors.
- 01
Using a binocular 6/6 reading to approve a Group 2 driver without measuring the poorer eye.
- 02
Interpreting the +8-dioptre spectacle limit as an absolute limit on all positive and negative lens powers.
- 03
Allowing a patched Group 2 driver to return because the diplopia has disappeared.
- 04
Applying DVLA administration to a Northern Ireland licence without directing the patient to DVA.
- 05
Assuming certification as sight impaired settles every driving, work or benefit question.