A once-in-a-generation opportunity: why our sector must get behind mandatory eye examinations for driving

By Daniel Hardiman-McCartney MBE FCOptom

The UK is on the cusp of a long-overdue reform. Moving from self-declaration to mandatory eyesight testing at licence renewal for older drivers is a once-in-a-generation chance to improve road safety, strengthen public health, and demonstrate the value of optometry-led care.

As a sector, we must be united in our support. But we must also be clear about what we are supporting: not a minimal vision check, but a full, optometrist-led sight test. This is vital because only a full sight test can detect asymptomatic eye diseases, initiate treatment and protect drivers' vision, a preventative approach to keep people driving safely. 

It relies on drivers recognising their own visual decline and acting on it, despite strong evidence that many do not. The number of drivers aged 70 and over holding a full licence has grown by 60% since 2012,  from 3.9 million to 6.3 million, reflecting an ageing population, rising life expectancy, and the reality that more people are driving for longer. Yet a 2024 roadside survey of over 3,000 drivers found that 1.7% failed a basic number plate test and a further 3.2%* received warnings or had their licence revoked, rising to a failure rate of over 10% among drivers aged 81 to 90. The tragic cases highlighted by the Senior Coroner for Lancashire, where poor eyesight contributed to fatal collisions, exposed the human cost of this systemic failure. A clinician-certified declaration must replace self-declaration.

A recent sight test at licence renewal ensures visual acuity is measured accurately and consistently, and that drivers requiring correction receive it. Many drivers technically meet the legal minimum but remain under-corrected, a risk that a simple screening test will not catch, but a full sight test will.

The processing of the renewal certification form could take place following a recent sight test and could include confirmation of the driver's VA with their habitual spectacles or contact lenses, and, of course, an ID check. This is an administrative separation between an NHS-funded sight test and driving renewal, with any certification costs paid by the driver, not the NHS. The vital part is that at the point of renewal, every driver has a valid sight test. Hundreds of thousands of drivers who currently have no regular sight tests would be brought into community eye care for the first time, forming a habit that improves vision, reduces the risk of preventable sight loss, and keeps them safer on the road for longer.

A sight test is not just a compliance check; it is a clinical encounter with the whole practice team, vitally including dispensing opticians who can ensure spectacles that are fit for purpose. It enables early detection of conditions such as glaucoma and macular disease, which are often asymptomatic in their early stages but can impair driving and cause avoidable sight loss. Identifying these conditions earlier is better for patients, better for the NHS, and safer for our roads. As a clinical encounter, visual field testing should be undertaken only where clinically appropriate, based on professional judgement of a qualified practitioner. This avoids unnecessary testing, reduces false positives, and ensures a more efficient and reliable improvement on the current self-declaration system. Introducing mandatory sight tests is likely to bring additional drivers into primary eye care, resulting in improved vision and earlier detection of eye disease.

As part of the sight test process, dispensing opticians should play a key role by checking that a driver's spectacles are current, serviceable, and fit for purpose for driving. This would include confirming that the prescription in use is up to date, that the lenses are appropriate for the individual’s visual needs, and that the frames are well-fitted, stable, and in good condition. 

The alternative is a separate visual acuity screening, but reducing this proposal to a basic screening would be a profound mistake. A check creates the illusion of safety while missing the broader clinical picture. It may even discourage people from attending full eye examinations, as they mistakenly believe a driving vision check is a substitute for a sight test, thereby worsening both road safety and public health outcomes. Every optometrist and dispensing optician will be aware of people who mistakenly thought their diabetic eye screening review included a sight test, resulting in years, sometimes decades of missed sight tests and worsened visual outcomes. This may be the same, but on a much larger scale. 

The sight test, already embedded in communities across every high street, is supported by professional standards and clinical governance. It is the most pragmatic, convenient, safe and effective solution available.

If we get this right, the impact will be profound: safer roads, earlier disease detection, and a stronger role for optometry at the heart of preventive healthcare. I hope the whole of the eye care sector responds to the Department of Transport consultation, supports this reform, and ensures it is delivered through comprehensive, optometrist-led eye examinations, not diluted into something less.