The study was designed to prospectively evaluate the driving habits of patients with retinal diseases, who were referred to the specialised retinal ambulatory care centre of the Landesaugenklinik Salzburg. The main purpose of this study was to compare the legal requirements for visual acuity, as currently valid in Austria and Germany for driving motor vehicles, with the results found in this patients cohort and to analyse driving patterns of the patients with valid licenses. With these data, it seems possible to suggest a suitable time for a legally mandatory eye examination as to identify subjects with a potentially rising higher accident risk when driving. In this study, 100 patients - all holders of a valid driving licence - with diabetic retinopathy or age related macular degeneration were enrolled. From each patient, the visual acuity (corrected or uncorrected depending on the driving habit) was recorded and a detailed questionnaire regarding the actual driving habits was requested. The resulting data were analysed in view of the legal requirements of both countries, Austria and Germany. Of 100 patients holding a valid driving licence a total of 31 were driving their motor vehicles with a legally insufficient visual acuity, 26 of 50 still driving. Of 50 patients suffering from diabetic retinopathy, 26 drove their cars illegally. Only 4 out of the above mentioned 31 patients had received sufficient information from their referring ophthalmologists. The average age of "illegal" drivers was 66.2 years. Within the European Community common legal requirements for driving a motor vehicle (regarding mainly the visual acuity) be clearly defined and a mandatory eye exam performed by qualified ophthalmologists for older subjects should be postulated. An individual and age related time limit to be placed on the driving licenses of persons suffering from systemic diseases associated with relevant visual loss should to be discussed. Furthermore, ophthalmologists should be obliged to give detailed information to the patient with adequate documentation. (A)
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