Socio-economic-legal

DVLA

 Stroke  1 month stop driving and no need to inform DVLA unless residual FND.
 VA and group 1 drivers = car + motorbikes
o Must be 6/12 (Snellen decimal 0.5) equivalent (best corrected) with both eyes open
or only eye if monocular
o AND be able to read in good lighting (w aids = glasses/lens)
 Pre-1/9/2001 license plate (79x57 mm) from 20.5 m
 Post-2001 license plate (79x50 mm) from 20m.
o Other requirements:
 120o horizontal visual field (50 left and right) and 40o vertical field (20 up
and down), with no central 20o defect.
 No legal requirements to drive motility scooters or wheelchair, although recommended
should read car plate from 40 ft (12.3 m).
 Group 2 drivers = HGV, buses, lorries
 Unacceptable fields are:
o Cluster of 4 or more adjoining points that is either wholly or partly within central 20o
area
o Loss of both a single cluster of 3 adjoining missed points up to, and including 20o
fixation and any additional separate missed point within 20o fixation
o Any central loss that is an extension of hemianopia or quadrantanopia of size > 3
missed points
 Once above age 70 – renew driving license q3y

BLIND REGISTRATION IN UK

 Glaucoma 10%; MCC blindness UK overall = AMD

 Loss of vision that affects day-to-day life
 It is voluntary but has benefits e.g. 50% off TV license.
 Worldwide cause of blindness = cataract > glaucoma > AMD > corneal opacities > DR >
childhood blindness > trachoma.
 Vision 2020 – right to sight. International effort made to eliminate avoidable blindness by
2020. Raises profile of avoidable causes; identify and secure resources; plan and develop 3
core strategies:
o Disease control, human resource development, infrastructure and apt tech devt.
Statistics

Prevalence = proportion affected by medical condition right now/during this time period
Incidence = new cases arising in population over a certain time.

Have disease No disease

+ve TP FP
-ve FN TN

SP = TN / (FP +TN) i.e. how good test is be negative in healthy (SPIN = rule in)

SN = TP / (TP+FN) i.e. how good a test picks up (SNOUT = rule out)

PPV = TP / (all +ve). Affected by prevalence. Higher Prevalence increases PPV

NPV = TN / (all –ve). Affected by prevalence. Higher prevalence decreases NPV

Events occur No event

Tx A B
Control C D

Odds ratio compares odds of event occurring in 2 groups. OR = 1 = no difference

OR = odds event on Tx / odds event in control = (A/B) / (C/D)

ARR = risk of event in control – risk of event on Tx

= [C / (C+D)] - [A/ (A+B)]

NNT =1/ARR