Driving and glaucoma in the UK: a national survey of clinicians' advice and guidance to patients.

Abstract

Driving standards policy is set by the Department for Transport and executed by the Driving and Vehicle Licensing Agency (DVLA). Professional bodies recognise the challenges that clinicians face when advising patients with glaucoma about driving. This study explored clinicians' knowledge and confidence around driving standards and their approach to advising and guiding patients. Cross-sectional online survey of all United Kingdom and Eire Glaucoma Society (UKEGS) members. The survey remained open for five weeks (22/02/21-27/03/21). Anonymised data were exported to Microsoft Excel for analysis. Out of 91 respondents (minimum response rate 20.2%), 53 (58.2%) were glaucoma consultants, 2 (2.2%) general consultant ophthalmologists, 4 (4.4%) ophthalmology fellows, 5 (5.5%) ophthalmology trainees, 19 (20.9%) optometrists, and 8(8.8%) 'other' categories (one SAS doctor, six specialist doctors, one nurse specialist). 58.2% reported that the visual standards for driving were 'very familiar'; 40.5% were 'moderately familiar'; one(1.2%) was only 'somewhat familiar'; none were completely unfamiliar. A total of 38 (41.8%) respondents were highly confident in giving advice on fitness to drive; 51 (56.0%) were moderately confident; 2 (2.2%) had only limited confidence. Over 25% review patients not meeting driving standards in every glaucoma clinic, over 50% identifying abnormal visual fields as the main reason. Our study found that most clinicians are familiar with DVLA driving standards. However, busy clinical environments limit detailed discussion about this, leading to only one in four clinicians being very confident to broach the subject with patients in clinic. A range of patient education modalities were suggested, which may help simplify advice provision for glaucoma patients.