Safe Driving - Assessment Mechanism to Reduce Morbidity and Mortality: A concept paper with reviewing a clinical case

Where a vehicle driver has multiple conditions or a condition that affects multiple body systems, there may be an additive or a compounding detrimental effect on driving abilities. An 81-year-old male motorcyclist was admitted to a tertiary care hospital following a road traffic accident. He has sustained only minor injuries.  No significant past medical history. He has monocular vision since 1960 following accidental trauma to the right eye. He had obtained a heavy and light vehicle driving license in 1958, which is valid for life. Driving with monocular vision is permitted in many European countries and Sri Lanka.   However, an important question remains - should the ability of driving be reviewed in an accident or any other condition which affects driving. This paper attempts to propose a referral mechanism to reduce morbidity and mortality in people with driving disabilities. Monocular vision affects vision in many ways. This might have serious implications both on the safety of the patient and the public. Driving with monocular vision is allowed in many countries. However proper evaluation of subsequent illnesses and referral mechanism is important in cases like this to reduce morbidity and mortality. In Sri Lanka there is no proper referral system for this. Therefore, we propose to introduce 1. Mandatory renewal of all driving licenses. 2. Mandatory notification system in conditions that affect driving 3. Issue a restrictive license and frequent review in relevant cases. This would be important in reducing injury risk to both the individual concerned and the public.