Commentary: Importance of ocular and systemic examination among state bus drivers

In a country like India where the main means of transportation is public transport, buses contribute to the majority of its part. Road transport corporation buses, either local or the interstate, are frequently used by the public for travel. The drivers are required to undergo the physical assessment test along with the ophthalmic status as a part of their screening and annual assessment thereafter. The complexities further magnify while driving heavy vehicles. This has caused an increasing number of accidents involving heavy vehicles in many Indian cities.[¹²]

Vision skills are among the prominent physical functions that assist a driver in perceiving traffic situations. These functions are difficult to quantify and to consider them in road safety evaluation is a difficult task. India follows a “single-phase licensing system,” which recommends a single phase of driver education and training prior to the written and driving test. Driver education is not mandatory and physical fitness of candidates with respect to visual abilities, hearing, etc. is not evaluated before issuing a driver license. Only the maneuvering abilities of drivers are considered sufficient for granting the license.[³]

The present study emphasizes evaluating the incidence of ocular and systemic disease affecting visual function among state transport corporation bus drivers in a South Indian district.

The study shows that visual function-threatening systemic diseases were present in 25.0% drivers, out of which diabetes mellitus (18.7%) was the most common pathology. The most common ocular problem was refractive error (45.0%). Visual function-threatening ocular diseases were present in 9.5% of drivers. Diabetic retinopathy, visually significant cataract, glaucoma, and central serous chorioretinopathy were noted in 4.0%, 1.9%, 1.7%, and 0.8% drivers, respectively. Surgical intervention was required in 2.2% of drivers.[⁴]

In a study conducted by Verma et al.,[⁵] where 387 drivers belonging to different organizations, age groups, and driving experience were studied. This sample included drivers from Karnataka state road transport, Bangalore metro road transport, and VRL (a private transport organization). More than half of the entire sample (52%) failed in at least one of the vision parameters tested. The results show a significant relationship between road-crash tendencies of drivers and visual defects such as phoria, peripheral vision, and contrast sensitivity.

A similar study conducted at Guwahati, Assam also identified several shortcomings in the visual capabilities of licensed drivers.[⁶] It was observed that out of the 189 licensed drivers tested for vision, 3% failed in phoria, 12% in depth judgment, 7% in glare recovery, 5% in nasal vision, 15% in acuity, 5% in night vision, and 5% in color vision. These results depict the flexibility in the current licensing practices, which may ultimately reduce driving safety.

There are however no sufficient data to assess and compare the much-needed importance of the visual assessment and various conditions affecting it among the public transport bus drivers. The health conditions of the drivers and their performance need to be given constant evaluation for the safety of the public and themselves.