Abstract

Where a vehicle driver has multiple conditions or a condition that affects multiple body systems, there may be an additive or a compounding detrimental effect on driving abilities. An 81-year-old male motorcyclist was admitted to a tertiary care hospital following a road traffic accident. He has sustained only minor injuries. No significant past medical history. He has monocular vision since 1960 following accidental trauma to the right eye. He had obtained a heavy and light vehicle driving license in 1958, which is valid for life. Driving with monocular vision is permitted in many European countries and Sri Lanka. However, an important question remains - should the ability of driving be reviewed in an accident or any other condition which affects driving. This paper attempts to propose a referral mechanism to reduce morbidity and mortality in people with driving disabilities. Monocular vision affects vision in many ways. This might have serious implications both on the safety of the patient and the public. Driving with monocular vision is allowed in many countries. However proper evaluation of subsequent illnesses and referral mechanism is important in cases like this to reduce morbidity and mortality. In Sri Lanka there is no proper referral system for this. Therefore, we propose to introduce 1. Mandatory renewal of all driving licenses. 2. Mandatory notification system in conditions that affect driving 3. Issue a restrictive license and frequent review in relevant cases. This would be important in reducing injury risk to both the individual concerned and the public.

Highlights

  • Where a vehicle driver has multiple conditions or a condition that affects multiple body systems, there may be an additive or a compounding detrimental effect on driving abilities

  • According to the WHO data published for the year 2018, road traffic accident deaths in Sri Lanka is around 3590 or accounting for 2.8% of total deaths.[1]

  • A conditional license with appropriate vehicle modifications is granted in Sri Lanka (SL).[6]

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Summary

Introduction

Where a vehicle driver has multiple conditions or a condition that affects multiple body systems, there may be an additive or a compounding detrimental effect on driving abilities. The drivers process information through visual inputs (90%), auditory inputs, or internal inputs.[2] Multiple conditions such as congenital disabilities (e.g. cerebral palsy, spina bifida), multiple trauma leading to neurological and orthopaedic injuries, aging-related changes, drug and alcohol addiction and multi-system disease (e.g. HIV, Diabetes) that affects multiple body systems, effect on driving abilities of an individual.[3] Globally the major causes of visual impairment are cataract and diabetic retinopathy.[4,5]. He has monocular vision since 1960 following accidental trauma to the right eye. There is a history of the patient meeting with repeated accidents since 1960

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