Commentary: Burden of refractive errors among commercial drivers.

With 1.1 billion living with a vision loss in 2020 as per the Global Burden of Disease report, almost 510 million individuals suffer from near vision impairment because of presbyopia, with a crude prevalence rate of 64·6 (47·1–84·5) cases per 1000.[1] This clearly points to the unmet visual needs and reduced awarness regarding solutions for refractive error across the world. The study by Kumar et al.[2] that explored the burden of refractive errors among commercial drivers in northern India reports a whopping proportion of 55.8% uncorrected presbyopia in the study sample.[2] The authors in this paper have also tried to explore the proportions of refractive errors, color vision deficiency, dry eyes, and stereo-deficiency among 281 commercial drivers.

Occupations such as driving require specific visual demands of static and dynamic nature. With the intricate visual demands required for driving, drivers are expected to meet the visual requirement standards to ensure driving performance and to meet the safety requirements. Beyond visual behaviors, cognitive mechanisms such as attention are also considered to influence driving.[3]

This paper[2] also highlights the prevalence of distance refractive errors to be 15.7%, with hyperopia being the most common of all. This points out to the age-related changes in refraction and the impact on visual performance. With respect to driving, association between experience of the driver, age, and the perceived visual difficulties is a worthy pursuit for further research studies.

It would also be interesting to understand the visual symptomatology of these individuals and the perceived difficulties because of dry eyes, deficiencies in color vision, and stereopsis. This would further help eyecare professionals to understand the visual requirements for driving.

The lack of general vision-specific criteria for driving license has been debated for a while now. Also, under-reporting of visual disability during the licensing process including inadequacies related to screening for chronic ocular diseases such as glaucoma and visual-field-related requirements has been pointed out in earlier publications.[45]

Future studies in India should explore the visual demands among commercial drivers, relevant to the dynamic driving tasks and vehicle requirements, and the impact of uncorrected refractive errors and ocular diseases on the visual requirements. This would enable framing of standard criteria for vision testing and methodologies to be adopted at a national level. Also, provision of refractive correction, modality of correction, and compliance with the same needs to be understood to be able to plan policies and service delivery models to combat the visual deficiencies in this sector. This study is indeed a good starting point for further explorations and a deeper understanding.