VISION SNAG OP-ED: A 10-year driving licence makes sense, a 10-year eye test gap does not

South Africa has decided to extend the validity of driving licences from five to ten years for certain categories of light motor vehicle licence codes. This change is aimed at reducing queues and administrative costs. However, critics argue that extending the licence validity without adjusting the eye test interval could lead to a lack of early detection and management of vision problems.

Current law mandates a mandatory eyesight assessment every time a licence is renewed. This creates an opportunity for vision screening for millions of South Africans, but extending the licence validity to ten years would increase the time between these assessments to up to a decade. Over such a long period, vision can change due to various factors such as refractive errors, cataract, glaucoma, diabetic retinopathy, and systemic conditions like diabetes.

Such changes in vision can significantly impact driving safety. A systematic review published in The Lancet Global Health found that central visual-acuity impairment is associated with a 46% greater risk of road traffic crashes in low- and middle-income countries. Therefore, extending the licence validity without a corresponding increase in eye test frequency raises public health concerns.

Moreover, South Africa faces a significant burden of chronic diseases, including diabetes. Progressive eye diseases like glaucoma, diabetic retinopathy, and cataract often develop gradually, and patients may not realize they are no longer meeting the visual requirements for safe driving. This issue is particularly relevant in South Africa, where access to large-scale screening programmes and eye care remains unequal.

The proposal to separate the licence validity from the eye test interval is not unprecedented. Other countries, such as New South Wales, New Zealand, and Britain, have adopted a similar approach. For instance, in New South Wales, drivers aged 21 to 44 can obtain a ten-year licence, while those aged 45 and older still undergo an eye test every five years.

New Zealand issues licences for up to ten years, but introduces medical certification and shorter renewal periods for older drivers. Similarly, Britain uses ten-year photocard licences but introduces shorter renewal cycles starting from age 70 and allows optometrists and ophthalmologists to initiate processes that may lead to a review by the Driver and Vehicle Licensing Agency.

These systems demonstrate that administrative validity and health surveillance can be separated without compromising safety or efficiency. South Africa could adopt a similar strategy by retaining the convenience of a ten-year licence while implementing proportionate periodic vision reassessment. This approach, coupled with risk-based reviews where clinically justified, would ensure that public safety and public health are safeguarded.

However, implementing such a system would require consultation with transport authorities, eye health professionals, public health specialists, road safety experts, and communities. Any new system must consider the unique context of South Africa, including its diverse population and existing healthcare infrastructure.