2010 BC Guide in Determining Fitness to Drive

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21.16 Snellen chart and standard ratings of visual acuityStandard ratings in feet and metresFeetMetres20/200 6/6020/100 6/3020/70 6/2120/50 6/1520/40 6/1220/30 6/920/25 6/7.520/20 6/620/15 6/4.520/10 6/3278
21.17 Visual field impairmentsTypes of visual field defects 13Type Description CausesLoss of all or part of thesuperior or inferior half of theAltitudinalvisual field, but in no casefield defectdoes the defect cross thehorizontal medianArcuate scotomaBinasalfield defect(uncommon)BitemporalhemianopiaBlind-spotenlargementCentral scotomaHomonymoushemianopiaConstriction ofthe peripheralfields leavingonly a smallresidual centralfieldA small, arcuate-shaped fieldloss due to damage to theganglion cells that feed into aparticular part of the opticnerve head, which follows thearcuate shape of the nervefiber pattern; the defect doesnot cross the horizontalmedianLoss of all or part of themedial half of both visualfields; the defect does notcross the vertical medianLoss of all or part of thelateral half of both visualfields; the defect does notcross the vertical medianEnlargement of the normalblind spot at the optic nerveheadA loss of visual function inthe middle of the visual field,typically affecting the foveacentralisLoss of part or all of the lefthalf or right half of bothvisual fields; the defect doesnot cross the vertical medianLoss of the outer part of theentire visual field in one orboth eyesMore common: Ischemic optic neuropathy, hemibranchretinal artery occlusion, retinal detachmentLess common: Glaucoma, optic nerve or chiasmal lesion,optic nerve colobomaMore common: GlaucomaLess common: Ischemic optic neuropathy (especiallynonarteritic), optic disk drusen, high myopiaMore common: Glaucoma, bitemporal retinal disease(e.g., retinitis pigmentosa)Rare: Bilateral occipital disease, tumor or aneurysmcompressing both optic nervesMore common: Chiasmal lesion (e.g., pituitary adenoma,meningioma, craniopharyngioma, aneurysm, glioma)Less common: Tilted optic disksRare: Nasal retinitis pigmentosaPapilledema, optic nerve drusen, optic nerve coloboma,myelinated nerve fibers at the optic disk, drugs, myopicdisk with a crescentMacular disease; optic neuropathy (e.g., ischemic,Leber's hereditary, optic neuritis); optic atrophy (e.g.,from tumor compressing the nerve, toxic/metabolicdisease); rarely, an occipital cortex lesionOptic tract or lateral geniculate body lesion; temporal,parietal, or occipital lobe lesion of the brain (stroke andtumor more common; aneurysm and trauma lesscommon). Migraine may cause a transient homonymoushemianopiaGlaucoma; retinitis pigmentosa or some other peripheralretinal disorder; chronic papilledema; after panretinalphotocoagulation; central retinal artery occlusion withcilioretinal artery sparing; bilateral occipital lobeinfarction with macular sparing; nonphysiologic visionloss; carcinoma-associated retinopathy; rarely, drugs13 From http://www.merck.com/mmpe/sec09/ch098/ch098a.html - Adapted from The Wills Eye Manual, Douglas J.Rhee, M.D. and Mark F. Pyfer, M.D.© 1999 by Lippincott Williams & Wilkins.279
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Ministry of Public Safety and Solic
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AcknowledgmentsResearcherBonnie M.
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Table of Contents (click on any ite
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11.7 Private and commercial drivers
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BACKGROUND ........................
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PART 1:BACKGROUND1
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Appendix 2: Excerpts from the MVA t
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Chapter 2: The Driver Fitness Progr
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for the exercise of discretion by O
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1. SCREENINGA driver disclosesa med
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2.3 Roles and responsibilitiesOSMV
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Medical practitionersMedical practi
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Chapter 3:Driver Fitness Program Pr
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Because of these limitations, OSMV
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Example: the temporary storage of i
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Motor functions (including sensorim
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an individual with poor contrast se
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3.5 Best informationDriver fitness
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Chapter 4: Introduction to the Poli
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3. DETERMINATIONFrom2. AssessmentAn
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Once identified, a DMER is mailed t
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5.3 Screening aging driversDefiniti
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5.5 Transient impairmentsDefinition
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Chapter 6: Assessment Policies and
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6.2 Assessments will only be reques
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6.4 Requesting specialist assessmen
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Policy6.5.1 If a case manager or ad
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Persistent and episodic impairments
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further assessment. Drivers who sco
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6.9.4 A case manager or adjudicator
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ASSESSMENT PROCEDURESCase manager o
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A driver fitness determination is a
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Policy rationaleBecause individuals
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7.5.3 Generally, an individual whos
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7.6.2 In particular, the case manag
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7.8.3 Whether an individual can com
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in order to be fit to drive, the ca
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has the judgment and willingness to
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Policy7.11.1 If a case manager or a
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(e) the medical condition results i
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7.12 Communicating a decisionPolicy
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7.13 Determination proceduresThe fo
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During the reconsideration, the adj
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8.3 Reconsideration proceduresThe f
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Chapter 9:Introduction to the Medic
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9.4 Medical condition chapter templ
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Private and commercial drivers who
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Chapter 11: Diabetes - Hypoglycemia
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PercentFigure 1 - Prevalence of Dia
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neuropathy, nephropathy, cardiovasc
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11.8 Private drivers with diabetes
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11.9 Commercial drivers with diabet
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RestrictionsRe-assessmentguidelines
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Policy rationaleSevere hypoglycemia
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11.12 Private drivers who have pers
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11.13 Commercial drivers who have a
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11.14 Commercial drivers who have a
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11.15 Commercial drivers who have p
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PART B - HYPOGLYCEMIA11a. Has the p
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Produce my glycemic log for my doct
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Deep-vein thrombosisDeep-vein throm
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Aneurysms less than 5 cm in diamete
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GUIDELINES12.6 Private and commerci
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12.7 Private drivers who have an an
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12.9 Commercial drivers who have an
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Chapter 13: Musculoskeletal Conditi
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ConditionType of drivingimpairment
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ConditionsRestrictionsRe-assessment
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14.3 Chronic renal disease and adve
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14.8 Private drivers with end-stage
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14.10 Private and commercial driver
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Level ofImpairmentMildlyImpairedMod
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15.8 Commercial drivers with modera
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15.10 Commercial drivers with sever
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Policy rationaleDrivers who require
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Chapter 16: Vestibular DisordersBAC
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One study identified that 32.5% of
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ConditionType ofdrivingimpairmentan
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Re-assessmentguidelinesPolicy ratio
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Individuals who have undergone valv
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Episodic impairmentThe potential ep
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GUIDELINES17.6 Policy rationaleThes
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17.9 Commercial drivers with corona
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17.11 Private drivers who have had
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17.15 Private drivers who have vent
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17.19 Private drivers who have sust
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17.21 Commercial drivers who have s
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17.27 Private drivers with atrioven
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17.28 Commercial drivers with atrio
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17.29 Private drivers with permanen
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17.31 Private drivers who have decl
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17.33 Private drivers where ICD the
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17.35 Commercial drivers who have d
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17.37 Commercial drivers with inher
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17.39 Commercial drivers with medic
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17.41 Private drivers with surgical
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17.43 Private drivers with mitral v
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17.45 Private drivers with congesti
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17.46 Commercial drivers with conge
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17.47 Private drivers with left ven
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17.49 Private drivers with a heart
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17.51 Private drivers with hypertro
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17.53 SyncopeSee the guidelines in
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Stable coronary syndromes - waiting
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Chapter 18: Hearing LossBACKGROUND1
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GUIDELINES18.6 Private drivers with
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equirement for commercial drivers i
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PLEASE COMPLETE THE FOLLOWING: YES
Page 241 and 242: this manual. Axis IV addresses exte
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Page 245 and 246: Schizophrenia (Axis I)Schizophrenia
Page 247 and 248: 19.4 Effect of psychiatric disorder
Page 249 and 250: Suicidal ideationSuicidal ideation
Page 251 and 252: GUIDELINES19.6 Private and commerci
Page 253 and 254: Chapter 20: Cerebrovascular Disease
Page 255 and 256: Cerebrovascular accidentCVAs are th
Page 257 and 258: ConditionType of drivingimpairment
Page 261 and 262: Re-assessmentguidelinesPolicy ratio
Page 263 and 264: 20.9 Private drivers who have had s
Page 265 and 266: 20.10 Commercial drivers who have h
Page 267 and 268: Visual field impairment refers to a
Page 269 and 270: Right homonymous hemianopiaBinasal
Page 271 and 272: An example of the effects of diabet
Page 273 and 274: Retinitis pigmentosaRetinitis pigme
Page 275 and 276: GlaucomaApproximately 67 million pe
Page 277 and 278: indicates that wait times of 6 mont
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Page 281 and 282: Policy rationaleretinopathy dependi
Page 283 and 284: Policy rationaleIndividuals with be
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Page 289 and 290: 21.13 Commercial drivers with a los
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Page 297 and 298: VISUAL FIELD TEST (VFT)For drivers
Page 299 and 300: To the Driver:Under section 29 of t
Page 301 and 302: Please note:Goldman, Esterman and H
Page 303 and 304: Cardiac syncopeCardiac syncope refe
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Page 311 and 312: 22.13 Commercial drivers with recur
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Page 321 and 322: 23.10 Private drivers with single u
Page 323 and 324: 23.12 Private drivers with epilepsy
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Page 337 and 338: ConditionsRestrictionsRe-assessment
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Chapter 26: Intracranial TumoursBAC
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Some examples of compensatory mecha
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i. aphasia (language disturbance)ii
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27.2 Prevalence and incidence of co
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27.4 Effect of cognitive impairment
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Chapter 28: Sleep DisordersBACKGROU
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An immediate reduction in daytime s
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28.5 CompensationIndividuals with s
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OSMV determinationguidelines cont
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ConditionsRestrictionsRe-assessment
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Policy rationaleThe general approac
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Chapter 29: Prescription and Over-T
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Examples of newer antihistamines in
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Stimulants (for ADHD)Examples of st
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AntiepilepticsIn general, individua
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Sedating EffectLowModerateHighTCAsd
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dizziness, andblurred or double vis
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30.2 Effect of general debility and
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Appendix 1: Glossary of TermsCommer
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Medical assessmentis any kind of as
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Transient impairmentmeans a tempora
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must cause to be issued to the appl
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(ii) cancel the person's driver's l
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Appendix 3: Aging DriversAbout agin
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Percentadults. The survey also foun
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Appendix 4: Licence ClassesThe tabl
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Appendix 5: Drafting and Approval P
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drivers, this means that BC commerc
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2010 BC Guide in Determining Fitness to Drive

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