It is the policy of the Department of Motor Vehicles, based on guidance and recommendations from the Medical Advisory Board, that individuals with known visual field loss of any kind or with high risk conditions leading to visual field loss should be reported to DMV.
DMV will issue an order of suspension upon receipt of documentation that a driver has a diagnosis of visual field loss that reduces horizontal vision to less than standards outlined in the Code of Virginia. The issuance of this order will be based upon an unacceptable vision report or unacceptable visual field analysis. In some cases, the Vision Screening Report (MED-4) will be sufficient to issue the order of suspension. In those cases, an individual wishing to protest the agency's decision to suspend his/her license must submit a Visual Field Analysis (VFA) for reconsideration.
Individuals with an acceptable Vision Screening Report (MED-4) who have a high-risk condition that can reduce the usable field of vision should have a baseline VFA performed. Conditions that are considered progressive, such as retinitis pigmentosa and glaucoma, will be followed at least annually. Repeat VF testing will be requested when changes are reported in the visual field or at a minimum of every 3 years.
High Risk Ophthalmic Conditions
Hemianopic Loss:
- Hemianopia (complete). Partial hemianopic defects may be considered safe for driving if the individual demonstrates an adequate field of vision in the unaffected side and the affected side retains or regains 30 degrees temporally with 15 degrees above and below the horizontal line for the full 30 degrees.
- Quadrantanopia (complete). Partial Quadrantanopia may be considered if the individual demonstrates an adequate field of vision in the unaffected side and the affected side retains or regains 30 degrees temporally along the horizontal line while demonstrating 15 degrees above and below the horizontal line for the full 30 degrees.
- Bitemporal hemianopia may drive if combined nasal measurement meets the VA standard for horizontal vision of 40 degrees to one side and 30 degrees to the other side for a minimum of 70 degrees total as demonstrated by VFA.
- Other visual field loss from strokes, tumors or compressive disorders
Optic Nerve:
- Glaucoma - Moderate to Severe stage
- Ischemic, traumatic, compressive, toxic or malnutrition related optic neuropathy
- Hereditary (Lebers) optic neuropathy
- Optic neuritis
- Optic nerve head edema - papilledema
- Optic atrophy
Retina:
- Proliferative diabetic retinopathy status post pan retinal photocoagulation
- Retinitis pigmentosa
- Retinal ischemia due to artery or vein occlusions
- Retinal ischemia due to uveitis etiologies both infectious and non-infectious
- Retinal detachment
- Retinal laser procedures
- History of retinopathy of prematurity or radiation retinopathy
Measuring Visual Fields
To determine visual field loss, DMV requires the results of a visual field test that measures the central 24 to 30 degrees of the visual field; that is, the area measuring 24 to 30 degrees from the point of fixation. Acceptable tests include the Humphrey Field Analyzer (HFA) 30-2, HFA 24-2, Octopus 32 or equivalent threshold perimetry test. In addition, testing needs to be completed to 120 degrees (60 degrees from the point of fixation) i.e. HVF 60-4 or equivalent.
DMV will not accept the results of visual field screening tests, such as confrontation tests, tangent screen tests, or automated static screening tests, to determine if the visual field meets DMV requirements if an individual has a condition that places them at high risk for visual field loss.
Eyeglasses should not be worn during visual field testing because they limit the field of vision. Individuals may wear contact lenses to correct visual acuity during the visual field test to obtain the most accurate visual field measurements.
When measuring the visual field, subtract the length of any scotoma, other than the normal blind spot, from the overall length of any diameter on which it falls. A scotoma is defined as a field defect or non-seeing area (also referred to as a “blind spot”) in the visual field surrounded by a normal field or seeing area.
Additional Documentation
DMV reserves the right to request that a driver provide additional information from a specialist in order to determine the severity of the condition and to assess the driver's ability to safely operate a motor vehicle.
DMV may also impose additional requirements on the individual depending on the information received.