Screening for diabetic retinopathy: a cause for concern in people who drive

• Published in: Diabetic medicine 2003-10, Vol.20 (10), p.812-815
• Main Authors: Razvi, S., Myers, L., Patton, K., McCulloch, A. J.
• Format: Article
• Language: English
• Subjects: Accidents, Traffic; Adult; Biological and medical sciences; Diabetes. Impaired glucose tolerance; Diabetic Retinopathy - pathology; driving; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Medical sciences; Mydriatics; Ophthalmology; pupillary dilatation; Retina - pathology; retinal screening; Retinopathies
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1046/j.1464-5491.2003.01036.x

Aims  To report a case of a road traffic accident in a lady driving home from a diabetes clinic after pupillary dilatation. We also present the findings of a questionnaire survey of health professionals to elicit their practice in dealing with such patients. Methods  We present the case report of a lady having a road traffic accident on her way back from a retinal screening appointment after having had pupillary dilatation. A subsequent postal questionnaire survey was undertaken to find out current practice in screening patients who drive on the day of their retinal screening. Results  A lady was involved in a road traffic accident whilst returning home after retinal screening. Her motor insurance company refused to cover subsequent claims for damage because her pupils had been dilated. She was also prosecuted by the police for driving without valid motor insurance. We conducted a postal survey of 500 health care workers including ophthalmologists, optometrists, diabetologists and general practitioners regarding the use of dilating drops in people with diabetes who intend to drive. Analysis of 320 valid responses confirmed that there is no consistent practice with regard to either the use of dilating drops in drivers or in ensuring that arrangements are made for subsequent adequate visual inspection in those whom dilatory drops are not instilled. Conclusions  Guidelines, for use by health care professionals and people with diabetes, are clearly required regarding the use of pupillary dilating drops in drivers.