Fitness to drive information for ophthalmologists and optometrists
Key points
- Fitness to drive may be an important consideration for people with some health and eyesight conditions.
- Eye health practitioners can provide advice about short and long term impacts of these conditions on driving and to recommend strategies for management and monitoring.
- The medical review process provides a mechanism for assessment and decision making about licensing, and for facilitating ongoing review if required. It aims to optimise driver capacity to drive in conditions that suit abilities, providing drivers are safe to do so.
- All drivers have a legal responsibility to notify Medical Review of significant long term health or vision conditions that may affect driving safety. Health professionals can advise patients of this responsibility and educate them about the medical review process.
- In most cases, referral to Medical Review doesn't result in licence cancellation. It may result in driving restrictions or medical monitoring to optimise future fitness to drive.
- Health professionals aren't legally mandated to notify Medical Review if a patient drives despite advice to the contrary. However they're ethically obliged to act in the interest of public safety. If they make a report to Medical Review they're protected from liability under Victorian Road Safety law. Reports can be anonymous.
Vision and fitness to drive
Driving is a complex task, which requires good vision, judgement, perception and physical abilities.
Many health and eyesight conditions may affect these attributes so fitness to drive should be a consideration for any patient presenting with visual system impairment.
Examples of eyesight conditions that may affect safe driving include:
- Visual field defects
- Visual acuity defects
- Monocular vision
- Diplopia
- Progressive eye conditions (e.g. cataract, glaucoma, optic neuropathy and retinitis pigmentosa)
- Congenital and acquired nystagmus
Visual system impairments are usually persistent, and some are progressive. The effect of multiple eye conditions and comorbidities and their treatments on driving should also be assessed and managed.
The diagnoses listed above provide a useful guide as to the type of eye conditions for which fitness to drive should be considered as part of overall management, either in the short or long term.
Assessing and managing fitness to drive can be complex and challenging. There's a need to balance importance of driving for an individual’s independence, social contact or employment with community safety.
What's my role as an eye health practitioner?
Your role is to provide advice to patients, carers and families about the impact of eyesight conditions and their treatments on driving and to make recommendations for management and monitoring.
To assist you, Austroads' Assessing Fitness to Drive (AFTD) is a national publication containing information about assessing and managing fitness to drive. Information is provided for both private and commercial licence holders. The document is also used by Medical Review to make decisions about licensing.
Reporting obligations
In Victoria, there's no mandatory reporting requirement for health professionals. However, you have an ethical and duty of care obligation to support public safety.
If you believe a patient lacks insight/judgement, and/or isn't heeding advice to cease driving or self-report, you may report directly to Medical Review using the online medical report. You can report anonymously.
If you believe the driver poses an immediate risk to public safety, you should report directly to Victoria Police.
Always keep up to date records in the patient’s file of the advice you give, copies of report forms and any actions you instigate regarding fitness to drive.
It's also important to advise your patient’s GP of your fitness to drive recommendations.
What are drivers’ responsibilities and how can I help my patients fulfil these?
You can explain to your patient that drivers are required by law to notify Medical Review of any long term or permanent medical or eyesight conditions or disabilities that may impact on driving in the longer term:
- when they apply for, or renew a licence, or
- as soon as possible when they become aware of new conditions/disabilities.
Such a notification will initiate the medical review process. Medical Review will request a fitness to drive eyesight and/or a medical report.
You can assist your patient to notify Medical Review by completing the eyesight report online.
What is Medical Review’s role?
Medical Review has a role in supporting health professionals to fulfil their patient advisory responsibilities.
Medical Review provides fact sheets that support conversations with patients about:
- vision and driving
- diabetes and driving
- the medical review process
- driving tests (medical review drive test and occupational
therapy drive test) - older driver issues (e.g. ageing and driving, health conditions and driving, retiring from driving).
While health professionals provide advice about fitness to drive, Medical Review is solely responsible for issuing, renewing, suspending, refusing or cancelling, or reinstating a person’s driver licence (including a conditional licence).
Most importantly, your patients should understand that having an eyesight condition doesn't necessarily lead to a loss of licence. Continuing licensure can be achieved through options such as conditional licences (no night driving, wearing corrective lenses) and regular reviews to monitor vision status.

Assessment considerations
a) Visual field assessment
Anyone who has, or is suspected of having, a visual field defect should have a formal perimetry assessment. If monocular automated static perimetry shows no defects, this is sufficient to show the standard is met.
Patients with any significant field defect and/or progressive eye condition require a binocular visual field assessment – generally the binocular Humphrey Esterman test or the Medmont Binocular Driving Test.
If using the latter, ensure that under the ‘Display’ tab the ‘Level’ map type is selected, as well as the ‘numeric’ data view. Also check the boxes ‘Numeric Tick Marks’ and ‘Annotations’.
For more details refer to AFTD guidelines (vision and eye disorders).
b) Colour vision assessment
There's no colour vision standard for driver licensing, either private or commercial.
Health practitioners should, however, advise drivers who have a significant colour vision deficiency about how this may affect road signal light responsiveness and the need to adapt their driving accordingly.
c) Contrast sensitivity
Reductions in contrast sensitivity should be considered in relation to vision system limitations and the application of relevant licence conditions (e.g. no night driving).
Are there special requirements for commercial drivers?
Reflecting the increased risks associated with driving commercial vehicles, more stringent health and vision standards apply to commercial drivers (e.g. truck, bus, taxi, bulk/dangerous goods and heavy vehicle drivers).
These requirements are outlined in Austroads' AFTD guidelines.
It's important for health professionals to ask about possible driving requirements for work so that the relevant standards can be applied. A person who does not meet the commercial vehicle medical or eyesight criteria may still be eligible to retain a private vehicle driver licence.
Resources
Austroads
Advice in this fact sheet is based on Austroads' Assessing Fitness To Drive guidelines.
AFTD is the national publication containing detailed information about clinical assessment and management of drivers, including criteria for determining fitness to drive for particular medical conditions.
Download a PDF of this page: Optical Review - fitness to drive information for ophthalmologists and optometrists (PDF).
Contact Medical Review
Email: [email protected]
Call: (03) 8391 3226
Fax: (03) 9854 2307
Mail: Medical Review
PO Box 2504
Kew VIC