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Keratoconus and driving vision: what you need to know

Eye Practice
Keratoconus and driving vision: what you need to know

If you’ve been diagnosed with keratoconus, one of your biggest concerns will often be whether you will lose your driving licence – or even get one in the first place. 

This post looks at what the reality is for most keratoconus sufferers and debunks some of the myths. 

Will I lose my licence?

This is always a concern, but in reality, if your keratoconus is properly managed, it is very unlikely that you'll lose your licence.  

We often see people who can’t get adequate driving vision in glasses and have been told they’ve failed in contacts. In fact it IS usually possible to achieve adequate driving vision with contact lenses. 


There are, however, a few exceptions to this. If you have corneal scarring from previous poorly-fitting contact lenses, a failed corneal graft, or corneal hydrops (a rupture of the cornea seen in severe keratoconus - pictured right) it may not be possible to meet the driving vision standard. 

Thankfully these conditions are very rare, even among keratoconus sufferers, and most people can achieve adequate vision to hold an unconditional driving licence. 

Don’t get caught on the keratoconus merry-go-round

The key to maximising your vision is to see a keratoconus expert early. It’s usually when this eye disease is mismanaged that you can get into tro

Seeing someone who only dabbles in keratoconus now and then is a recipe for disaster – it’s not unusual to end up with poorly fitting, uncomfortable contact lenses and to be told you have ‘failed’ in contact lenses. uble.  

It may be that they just haven’t explored all the options. It takes a great degree of experience and commitment to explore all possibilities, including scleral contact lenses, and come up with a comfortable and safe solution. 

A common scenario is that an eye care practitioner - optometrist or ophthalmologist - cannot provide you with clear, comfortable vision with glasses or contact lenses. So you try someone else. And someone else. Doing your research in the first place means you can achieve your best possible vision earlier and enjoy most aspects of life to the full.

What do you need to see to drive?

letter-chartMost people think you need 20/20 vision to drive, but this is not true. 20/20 is normally the smallest line of letters that most people can read on the eyesight chart at 20 feet (6 meters) when they are wearing the best possible pair of glasses – or when they have naturally perfect distance vision. Most people who legally drive do NOT have 20/20 vision. 

But the actual standard to hold an unconditional licence is that one eye must have 20/40 (6/12) vision. On the eye test chart, this is usually the 4th or 5th line from the bottom. 

Your keratoconus expert needs to keep this standard in mind when fitting your contact lenses.

Ideally, your contact lenses need to provide at least this level of vision – if not better. Seeing someone experienced in this area will ensure you have the best chance of seeing well and retaining your licence. 

Is night driving becoming more challenging?

As xenon, halogen and LED headlights gain more market share, night driving is becoming more difficult. Brighter headlights, which are higher off the ground (due to the shift towards SUVs) mean more glare and starburst from oncoming traffic. This is particularly difficult for anyone with compromised vision – including keratoconus sufferers. 

The good news is that, the clearer your vision, the less glare and starburst you will experience. Wearing glasses or (more often) hard contact lenses to maximise your vision will make your night driving more comfortable. 

No matter how clear your vision is during the day, you’ll still have more problems with night vision compared to the general population because of the distortion in your corneas. But for most people with keratoconus, it won't keep you off the roads.


Worried that your keratoconus diagnosis will cost you your driving licence?  Talk to the experts. Call The Eye Practice on (02) 9290 1899 or make an appointment online today. 


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