Alternative to Field tests?

[Piggy-in-the-middle]

I failed the DVLA test recently after taking them for over 10 years. I wasn’t surprised because I had noticed my vision was getting worse and that everyone else seemed to be driving too fast. What is confusing me is that my consultant says there is no deterioration, only the same amount of damage as before and that their field tests support this. I don’t want to appeal, I just want to understand. Are there any other tests that would measure speed of response to changes in field of view? Why would the DVLA field test with both eyes at once give such a different result from hospital tests with each eye separately? And where is the damage that is affecting my reaction speed?

[Jellymanpeanut]

I am enrolled in an eyecatcher study at city university in London. It’s a new form of field test. If you just google eyecatcher you should find some info on it. Hope that helps.

[Piggy-in-the-middle in reply to Jellymanpeanut]

This looks really interesting, it's taking me a while to read through the research. How are you getting on? do the test results correspond to your experience of your vision?

[Mangobrain]

it might be the opticians do not have machine set correctly. Spots are to be set at a certain level, bar in middle removed with or without glasses. Might be worth paying for one at a different opticians that do dvla checks, should be in letter sent to you.

[Piggy-in-the-middle in reply to Mangobrain]

I’ve had many field tests of both sorts, with and without glasses, but don’t know what metric the consultant is using to say there is no deterioration. The dvla tester specifically mentioned spots in the centre of my field of view, which doesn’t seem to be reflected in the hospital metric. It was clear to me that my driving was already affected so I was relieved to stop before I had any accident.

[Beecalmed in reply to Piggy-in-the-middle]

Hi! If you have the printout from DVLA test then ask to see consultant and compare to your fields done at the hospital it will show if there’s points missing centrally. If NHS too busy then find and see a private consultant if you can.

Also if you are losing central spots your hospital should be using a different field test that checks the central area more closely. The hospital won’t do this until they perceive central loss. Currently they perceive none. But DVLA have so you need that checked by the hospital now. This is a regardless of whether you want to drive. You want to be sure to hold all the cards to preserve your vision.

I also think that how our individual brains process information from our eyes may be different in each of us. I know I “see” my scotoma even with both eyes open which I shouldn’t be able to do according to my consultant. I have surmised this is because my brain is trained to make my right eye dominant and ignore left. I was a photographer for years and artist and so needed to focus with right eye and my brain needed to shut out left eye info, sometimes without me needing to necessarily close it. Consequently I have an issue that when I close my right eye now, my left vision “sees” the black of the closed lid in the right as it is still the dominant eye, and it distracts me from what I see in a field test and lights. If I blink I can reset my brain for a few second. So I blink, constantly, in the test. Going forward I am now trying to retrain my brain to make my left eye dominant as that eye has better vision.

I see the fault in vision in my right eye with both eyes open as a slight shimmer outline. If you have ever watched the movie “Predator” then I see something like the alien when he has his chameleon cloak on. 😂 A shimmer outline on the image just where my black spot is.

If you are not seeing things when moving and skiing etc then that does sound like that is a depth of field issue. Your eyes are not operating to help you judge distance to objects correctly. That does sound like your brain is struggling to process information or is distracted. Regardless of the DVLA situation if I was you I too would want to understand it better as it is affecting your confidence and ability to function. Do hope you get more info. 🤞🏻I also applaud your honesty in being relieved not to drive. Too many people see driving as a right and not a gift. The roads would be safer if more people had your self awareness and honesty. I applaud you for that too. 🙂

[Piggy-in-the-middle in reply to Beecalmed]

You make a lot of good points. Yes I really wish I had copies of all the field tests I've ever done! But my concern is understanding current results. Like you my right eye is dominant - to the extent that I've never had stereo vision, which is why I rely on good vision to judge position and speed. And my brain does try and overlay the view from each eye too sometimes which can be really distracting. Good luck with retraining your dominant eye, I practise with my weak eye just to preserve it's vision. I spent my whole career in sensor systems and image processing, even wrote algorithms, so I find my failing abililty completely fascinating. On the field test for example, just looking at the white box I see a lot of fast changing noise "boiling" patterns even before the lights start. Maybe that's a glaucoma effect? Because of not using my eyes together I can be fairly sure my brain won't have the "normal" visual wiring. But all the usual building blocks are there. I realise the eyeball itself has many different motion modes which are all used to produce a seamless view of our place in a changing sene, hence at the moment I'm experiencing a time delay when looking at things rather than actual blind spots. And thank-you for your kind words about driving, it is difficult depending on others, although so far there's always been alternatives and I have a lot of support from friends & family as well as good public transport locally. And no more tip runs!

[Dumyat26]

Do you ask for printouts of your results? I have only recently found that you are entitled these and so only have 2 years of records so far but find that they do help in understanding my condition and seeing if there is any change. As I've said in other responses the DVLA test is only interested in a field of vision which equates to an "envelope" area across the central vision. So in my case I have 30% loss of FofV in left eye and 10% right eye. But as these areas are to the top of eye they do not impact much on the critical area.

[Piggy-in-the-middle in reply to Dumyat26]

Yes I have printouts and can see things are getting steadily worse. As above; the dvla tester specifically mentioned spots in the centre of my field of view, which doesn’t seem to be reflected in the hospital metric. It was clear to me that my driving was already affected so I was relieved to stop before I had any accident.

[Sorshup]

We are stuck with the DVLA "drivers field of vision test", no matter what other tests are developed. As has been said, requesting DVLA to accept another test and their assessment of this is quicker than appealing. Your consultant is concerned only with what info that the VF test (and iops) prompts his medical or surgical intervention. for you. I suspect you have been close to DVLA licence cancellation for a while but the small change that tipped you over there was not considered significant to the consultant, hence his opinion of no deterioration.

[Piggy-in-the-middle in reply to Sorshup]

Yes, I started with 3 year tests andcthen several annual ones. For the last couple I could almost hear the sharp intake of breath when they saw the printout! so I was ready to stop driving. The consultant didn’t accept the mismatch between my vision and the hospital observations. After talking it over with my GP the glaucoma clinic is now referring me for an MRI scan.

[Gilbert1908]

Hi can you say how you got on since. Your post.thank you nick

[Piggy-in-the-middle in reply to Gilbert1908]

As above; the consultant didn’t accept the mismatch between my vision and the hospital observations. After talking it over with my GP the glaucoma clinic is now referring me for an MRI scan. I don’t think (hopefully) that there’s anything to find, rather that current tests don’t capture much detail of the affects on processing due to glaucoma.

[Gilbert1908 in reply to Piggy-in-the-middle]

Hi the hospital sent me for scan.they said the readings the.spechalist.saw,where very rarer, scan didn't show anything.good like.

[Piggy-in-the-middle in reply to Gilbert1908]

The hospital thought the scan would be quite soon, and then I'll have another appointment in the glaucoma clinic.

[Trish_GlaucomaUK Partner]

You do not mention whether your test for the DVLA were yearly or every 3 years. If it is yearly, this would mean that you have been borderline to reach the standards set by the DVLA. The test is done with both eyes open to measure the full peripheral when driving.

The reason the test is done one eye at a time at the hospital is so they can check optic nerve damage in each eye, as these will differ in severity.

Reaction to acknowledging lights is caused by blind spots caused by the glaucoma.

Reaction itself for any reason is not caused by glaucoma.

[Piggy-in-the-middle in reply to Trish_GlaucomaUK]

My understanding of glaucoma is in early infancy. I was told it was the processing that was affected by nerve damage. That could lead to blind spots, or spots where it takes longer to respond to changes. But for me it was specifically how quickly I noticed changes. I had to give up downhill skiing first because I just couldn’t see what was happening and reacting in time.

[Sorshup]

I think you are leading yourself down a blind (sorry) alley. Glaucoma, at is simplest, is the death of retinal nerves - no longer carrying the message from receptor to the optic nerveand thence to the brain. As more nerves die the retina needs the image to be brighter for it to be detected, in the affected part of the retina. One's actual physical and mental reaction and response to light may well be affected by the weakness of detection and area of visual field affected, and this indeed is cerebral processing but is caused by uncertainty - did I see the visual field test light or not? Why didn't I see that undulation in the ski slope? . Unless your consultant is checking for other pathology than glaucoma, there is no appropriate MRI investigation of the eye. Or is this MRI to be of your brain, regarding all your reaction times?

[Piggy-in-the-middle in reply to Sorshup]

I think this will be a brain scan. There are many differnt aspects, because the eye has various modes of motion, at the moment there is just a delay for me until enough signal falls on an undamaged part of the retina. Someone points at the sky saying "Look at that!" and there's a pause before I can say "Wow, amazing!"

[Dumyat26]

Do you ask for printouts of your results? I have only recently found that you are entitled these and so only have 2 years of records so far but find that they do help in understanding my condition and seeing if there is any change. As I've said in other responses the DVLA test is only interested in a field of vision which equates to an "envelope" area across the central vision. So in my case I have 30% loss of FofV in left eye and 10% right eye. But as these areas are to the top of eye they do not impact much on the critical area.

[Piggy-in-the-middle in reply to Dumyat26]

I've never had stereo vision so damage in one eye cannot be compensated for by the other eye. That's another reason why I don't understand the different results from the DVLA (two-eyed) test and the hospital (separate eyes).