Driving and vision changes after stroke

This guide aims to inform those with a static visual field defect of the Driver and Vehicle Licensing Agency (DVLA)’s route to potentially regaining a driving licence.

A visual field defect is a loss of part of the field of vision. The field of vision is the entire area that can be seen when the eyes are focused on a single point, with head held still.

 

Medical terms for visual field loss defects include Homonymous Hemianopia or Quadrantanopia. This is where half or a quarter of the visual field, respectively, is lost from both the right and the left eyes (bilateral).

 

Driving after a stroke: the basics

• You must not drive for the first month after a stroke or single Transient Ischemic Attack (TIA). If you have had multiple TIAs, then you may be banned from driving for three months. This restriction is in place regardless of whether your vision has been affected by the stroke. The DVLA do not need to be informed at this stage.

 

• You may return to driving if, after the initial month, the clinical recovery is satisfactory and there are no residual effects, such as seizures. If vision was initially affected but has been restored, you may be required to pass the legal eyesight standards (DVLA INF188/1). Medical professionals can support you in determining the above.
  • INF188/1 a guide to standards of vision for driving

 

• If vision issues persist after the first month, the DVLA must be informed. This is a legal requirement of the licence holder.

 

• At this point, the DVLA will consider whether the licence should be revoked for failure to meet the minimum eyesight standards (acuity, visual field capacity, eye movement, and perception).

 

• The licence holder can voluntarily surrender their licence using the DVLA’s “Declaration of Surrender for Medical Reasons” online form.
  • Voluntary surrendering licence form

 

• Failure to inform the DVLA could result in a £ 1,000 fine, invalid insurance, and /or legal action, and may bar access to the DVLA’s “exceptional case” pathway.

 

The DVLA “exceptional case” rule

Those who have lost their entitlement to drive because of a static visual field defect (permanent visual field loss) can have their licence reissued, subject to strict criteria and a driving assessment.

 

The DVLA will consider an application under the “exceptional case” criteria. The DVLA will check that the visual field defect is not caused by a condition considered to be progressive in nature, and that the applicant has fully adapted to the presence of the defect. The criteria are as follows:

1. Defect must have been present for at least 12 months
2. Caused by an isolated event or a non-progressive condition
3. There must be no other condition or pathology regarded as progressive and likely to affect the visual fields (such as glaucoma or retinitis pigmentosa)
4. Sight in both eyes (there are separate rules for driving with monocular vision – see page 7)
5. No uncontrolled diplopia (double vision)
6. No other impairment of visual function (such as macular degeneration), including no glare sensitivity, contrast sensitivity or impairment of twilight function
7. Clinical confirmation of full functional adaptation

 

Visibility Scotland’s neurological stroke and acquired brain injury-specific vision rehabilitation scanning programme can help people meet this final requirement. However, only medical professionals can officially sign off on these criteria. This is likely to be a GP, Orthoptist, Optometrist (Optician) or Ophthalmologist, and is carried out at the next stage (see “exceptional criteria evidence form” section).

 

To find out more about Visibility Scotland’s scanning rehabilitation, please contact us directly. At the time of writing this, rehabilitation is being offered on a one-to-one basis, free of charge, to people living within the Greater Glasgow and Clyde NHS area. This is conducted from our office in Glasgow. Those outside of this area can still receive information on scanning rehabilitation in an accessible format. A link to our webpage is below:

Stroke and brain injury support – Visibility Scotland

 

A note on monocular vision and driving

• Generally, you do not need to inform the DVLA if you have monocular vision, provided you’re still able to meet the driving vision standards (INF188/1). A medical professional can advise here.
  • Monocular vision and driving

 

• If your monocular vision was caused as a direct result of a stroke or other neurological event, then you must inform the DVLA, as you would be living with visual changes one month after the event. The DVLA will likely then seek to determine if you are still able to meet the visual requirements for driving (INF188/1). The DVLA also suggest that it may take up to three months to adapt to monocular vision.

 

If you have a health condition affecting your functioning eye, check the rules for that condition in the section on health conditions and driving. This is available through the DVLA’s website:

DVLA health conditions and driving

 

Beginning the exceptional cases application process

The exceptional cases process is initiated by you contacting the DVLA directly and informing them you wish to reapply for your licence. The DVLA will likely require applicants to take the standard visual field test initially. This is currently administered exclusively by Specsavers Opticians.

 

Those who have adapted to their visual field defect will still likely fail this test, as the vision loss is still present. This is a necessary step in order for the “exceptional case” pathway to be activated.

 

The next stage will consider your adaptation to visual field loss, specifically how well you can scan to ensure your vision loss does not slow or impede function, and you can identify hazards, thereby fully compensating through more efficient use of your unaffected visual field.

 

The “exceptional criteria evidence form”

Following the failure of the standard visual field test, your medical professional will need to complete the “exceptional criteria evidence form” (EXCVIS Reply Form). This is to provide a medical opinion based on evidence, of satisfying the criteria (listed previously) for the next stage, the on-road assessment.

 

Please note: The exceptional cases pathway, including the on-road assessment, is a “single-attempt” process. If failed, it cannot be re-taken.

 

The on-road driving assessment

On receipt of the “exceptional criteria evidence form”, from your medical professional the DVLA will consider your fitness to drive and decide if you qualify for the on-road driving assessment. This is not a driving test, but an assessment of your safe driving with your current vision.

 

The DVLA will issue you a provisional disability assessment licence (PDAL) to undertake any driving lessons you may wish to have and to take the on-road assessment itself. The DVLA states that the PDAL allows for a period of two months for the assessment to be undertaken from the date of issue.

 

You can find a list of local disability driving instructors at the following link:

Disability driving instructors

 

At the assessment

The assessment is not a driving test, but rather an evaluation of your fitness to drive and your ability to drive safely. Therefore, you will be asked about your medical condition and any medications, glasses, or mobility aids you are currently using.

 

You may also have your physical ability assessed (range of movement) and your mental skills assessed through a series of puzzles or tests. This is standard practice for those having the assessment after neurological events such as strokes.

 

The on-road assessment will then take place, and you will be asked to drive a route unfamiliar to you. The car will be supplied by the centre, be dual-control, and will be manual or automatic, based on the provision of your original licence. It may be possible to change from a manual licence to an automatic licence, if wished.

 

Results of the assessment

The results of the assessment, along with all the information received as part of the DVLA medical enquiries, will be reviewed by a DVLA doctor. This will be used to decide whether your driving licence will be reissued.

 

Additional notes and information

• Being registered as vision impaired is not a barrier to the “exceptional case” pathway, and the DVLA would not require any such registration to be relinquished.

 

• This document focuses on vision in relation to the DVLA “exceptional case” pathway. There may be non-vision health issues which will need to be taken into consideration.

 

• Success with the “exceptional case” pathway may result in more frequent renewal of the licence. The DVLA will provide clarity on this upon re-issue.

 

• The exceptional case pathway should not incur any charges, apart from a small administration fee of £17.00 (at the time of writing) for issuing the PDAL. The individual would have to pay for any private lessons before the on-road assessment, but the assessment itself and the use of the assessment centre’s vehicle should be free.

 

• Although vehicle insurance premiums should not be adversely affected by one-off health events, it may be the case that an individual loses their accrued “no-claims discount”.

 

• It is advisable to keep your insurer informed of your medical history to ensure that policies are not invalidated.

 

• The “exceptional case” pathway is conducted on a case-by-case basis, and individual experiences may differ from the information contained here.

 

Assessment Centre Details for Scotland

Edinburgh

Scottish Driving Assessment Service

SMART Centre, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2HL

0131 537 9192

Lothian.scottishdrivingassessmentservice@nhs.net

 

Glasgow

DriveAbility Scotland

75 Hawthorn St., Glasgow, G22 6HY

0141 648 8470

info@driveabilityscotland.org.uk

DriveAbility Scotland

 

DVLA contact information

To contact the DVLA about a medical condition, use the following contact information:

DVLA Medical Enquiries
Telephone: 0300 790 6806
Monday to Friday, 8am to 7pm
Saturdays, 8am to 2pm

Email: medadviser@dvla.gov.uk 

 

Information contained in this guide is correct as of July 2025.

 

Acknowledgements

Visibility Scotland is grateful to the following individuals for their input and expertise;

• Dr. Charlie Chung – Consultant Occupational Therapist/Allied Health Professions Stroke Strategic Lead, NHS Lothian.
• Jacqueline Pentland – Senior Occupational Therapist, Edinburgh Community Rehabilitation and Support Service.
• Colin Hilditch – Head of Enterprise, Sight Scotland.