ROAD SAFETY AND VISION

A reform of visual acuity tests for driving licence applicants has been successfully included as an integral part of Morocco’s efforts to improve its patchy road safety record.

“Morocco has been making major efforts to reform the system for the attribution of driving licences and thereby helping to reduce its very high road accident rate, which is one of the highest in the region,” Adil Mchachi MD told delegates attending the annual meeting of the French Society of Ophthalmology (SFO).

Dr Mchachi said that the goal of his study was to evaluate the presence of visual problems in candidates presenting for their driving test in Casablanca, Morocco, and to highlight the importance of an ophthalmic examination for the benefit of road safety and general health.

Reform Necessary

The road accident statistics for Morocco underscored the primary reason why the government felt that reform of the driving licence attribution system was absolutely necessary, said Dr Mchachi.

“Around 3,838 people are killed on the roads in Morocco annually for a population of 32 million inhabitants and 2.7 million vehicles. That equates to 28.7 people killed per 100,000 inhabitants. In France, the figure is 7.5 deaths per 100,000 inhabitants, which is a lot less than Morocco,” he said.

These stark figures gave rise to a series of legislative reforms governing road safety and driving licence attribution in 2010 and 2011.

Under the old system, basic eye examinations were conducted by the ophthalmic service of designated hospitals, with an overall measure of visual acuity for both eyes being used to establish a candidate’s aptitude to drive.

New laws

Under the new laws, a multidisciplinary approach has been introduced using physicians from both public and private sectors to carry out a wide range of medical tests: cardiology, neurology, respiration, muscular-skeletal etc. In addition to visual acuity, the requirements for visual aptitude have been widened to include tests for visual field, colour vision, diplopia, hemeralopia, nystagmus and hemianopia.

Dr Mchachi’s study collected socio-demographic and visual acuity data of driving licence candidates at the ophthalmic service of the “20 August 1953” Hospital in Casablanca over a one-year period from January 2012 to January 2013. Data from complete ophthalmic examinations on those candidates who failed to meet the initial visual requirements or where ocular anomalies were detected were also collected.

A total of 3,600 files were examined with an average of 15 candidates a day over the one-year period. The mean age of the candidates was 34 years (range 18 to 72), of whom 72 per cent were male.

The results overall showed that binocular visual acuity was 10/10 or better in 52 per cent of candidates, between 7/10 and 9/10 in 32 per cent, 3/10 to 7/10 in 12 per cent and less than 3/10 in four per cent of candidates.

More Screening Needed

For those patients who underwent a complete ophthalmological examination, problems diagnosed included non-corrected refractive errors in 16 per cent, ocular surface problems in nine per cent, cataract in six per cent, diabetic retinopathy in four per cent and glaucoma in two per cent. The main treatable causes of disqualification for the licence included refractive problems, certain ocular surface pathologies and cataract.

Summing up, Dr Mchachi said that refractive problems were frequently under-diagnosed as they often only came to light at the time of the eye test for the driving licence. He suggested that more screening in educational establishments or work places might help to detect some of these problems earlier.

Adil Mchachi: adilmchachi@gmail.com