Driving visual-field reporting checklist for clinicians

Start with the original printout, not the patient story alone. Confirm the patient identity according to your clinic workflow, test date, device, test strategy, and whether both eyes were tested together.

Check whether the patient wore their usual driving correction when appropriate. The Optometry NSW/ACT guide notes that corrective lenses should be worn if the patient usually drives with spectacles or the licence is conditional on spectacles, and that no near addition is required for the binocular Esterman screening-style test.

If the printout is cropped, unreadable, or missing the reliability header, fix that before interpreting the field.

Record whether fixation monitoring was performed and recorded. Record the false-positive score. If false positives exceed 20 percent, the field is not reliable for a favourable licensing interpretation under Austroads.

If reliability is acceptable numerically but suspicious clinically, document the concern and consider repeating. Examples include inconsistent patient responses, poor position, obvious artefact, or a field pattern that does not match the disease.

For roving Esterman, check that there are two consecutive tests, false-positive counts for each, and a numeric point map.

Confirm the grid matches the printout. Mark missed points carefully. Then review horizontal extent, central 20-degree pattern, meridian-related concessions, and neurological encroachment.

Horizontal extent is measured from seen point to seen point. Do not measure from the first missed point. Do not assume a smooth contour between tested points.

If the result is at or near 90, 110, or 140 degrees, slow down. Small point-entry errors or wrong-grid selection can matter.

Document private versus commercial. For private borderline fields, record whether conditional consideration is being discussed. For commercial fields, be clear about stricter expectations and any limitations.

If the patient is monocular, recently monocular, has a neurological defect, has progressive disease, or has an unusual device pathway, include that context in the report.

If the patient drives long distances, heavy vehicles, at night, or in a professional capacity, those details may matter for authority decision-making even when the field measurement looks simple.

A good report includes the source printout, reliability, field extent, central-field pattern, licence class, and limitations. It should avoid unsupported conclusions such as "safe to drive" when the finding is really "may support conditional consideration".

Use plain clinical language. The licensing authority and patient may not understand app-specific reason codes. Explain what the pattern means and what should happen next.

Include the decision-support boundary: the driver licensing authority makes the final decision, and the report should be read with the original printout and the Austroads standard.

Do not issue a favourable report if the printout source is unclear, reliability is inadequate, the grid is unsupported, the field is below the relevant threshold, or the central/neurological pattern is unacceptable.

Do not soften uncertainty because the patient needs the licence urgently. Instead, recommend repeat testing, specialist review, or manual authority review.

The most defensible report is the one that clearly explains what is known, what is uncertain, and why the next step is appropriate.

Keep the original field printout, not only the DRIVE Fields summary. The printout contains the source evidence: tested points, device pathway, reliability data, and any clues about artefact or printout mode.

If you send information to a driver licensing authority, make sure the packet is coherent. The authority should be able to match the clinician statement to the original printout and understand whether DRIVE Fields was used as decision support rather than as the source test.

For practice teams, a simple naming convention helps: test date, patient identifier according to clinic policy, device, Esterman or equivalent strategy, and whether the result was standard or roving. That makes later review much less painful.