Inadequacy of self-assessment of vision, and fitness to drive.

The author, a retired neurosurgeon then aged 81, describes his own right upper quadrantic homonymous visual field defect which did not impair any normal daily activities. His own occupation allowed him to recognise the defect. It is unlikely that such a defect would have been noticed by other elderly persons. The field defect shown by perimetry (illustrated) debarred him from driving. Self-assessment of visual acuity, and especially fields, is inadequate when applying for renewal of a driving licence. Effective steps to prevent such licensing and the damage that may follow are discussed.