Vision screening tests for elderly drivers may not necessarily result in fewer motor vehicle crashes and related fatalities, according to a review published in the January 21 issue of The Cochrane Library.1 Due to the development of vision-impairing conditions with age, the authors hypothesized that elderly drivers may be involved in more car accidents than younger drivers.

But, after analyzing more than 4,500 published and non-published studies, the authors could not determine if visual screening examinations and license restrictions for elderly drivers would significantly reduce crashes and fatalities. 

By comparison, the number of fatal crashes involving elderly drivers in Florida decreased by 17% following passage of a mandatory vision screening law on January 1, 2004,
according to a study in the November 2008 Archives of Ophthalmology.2 Drivers over the age of 80 must pass a vision exam before the state will renew their licenses; the applicant must demonstrate an uncorrected acuity of 20/70 or better O.U. But, the authors could not establish a link between reduced acuity and increased risk for fatal crashes among elderly drivers.

About 93% of individuals who sought license renewal passed the vision test, which indicates that a very modest number of elderly drivers were actually removed from the road, says author Gerald McGwin, Jr., Ph.D. Additionally, the law may have forced other elderly drivers to recognize their level of visual impairment and not seek license renewal. Dr. McGwin concluded that future age-related vision screening laws should target high-risk drivers, while still allowing low-risk drivers to renew their licenses.


1. Subzwari S, Desapriya E, Babul-Wellar S, et al. Vision screening of older drivers for preventing road traffic injuries and fatalities. Cochrane Database Syst Rev 2009 Jan 21;(1): CD006252.
2. McGwin G Jr, Sarrels SA, Griffin R, et al. The impact of a vision screening law on older driver fatality rates. Arch Ophthalmol 2008 Nov;126(11):1544-7.

Vol. No: 146:02Issue: 2/15/2009