When Is an Ophthalmologist’s Report Required?
For most people, the eye test for a driving licence is a quick visit to the optician, a few minutes with the Landolt rings, and a certificate to take to the authority. Sometimes, though, the authority asks for more: a report from an ophthalmologist, known in German as an augenärztliches Gutachten. The letter can be worrying if you do not know what it means, because it sounds like something has gone wrong with your eyes, but in many cases it is simply a routine check. This guide explains when an ophthalmologist’s report is required, what it contains, how the process works, and what you can do if the report is not in your favour.
An ophthalmologist’s report is a medical opinion, not a measurement. It is written by an eye doctor, usually a specialist in ophthalmology, and it answers the driving licence authority’s questions about whether your eyes are fit for driving, and under which conditions. It is more thorough than the simple eye test, it takes longer, and it costs more, but it is also more precise, and in some situations it is the only document the authority will accept. Knowing when it is required helps you to avoid surprises and to plan the application properly.
The ordinary eye test and the ophthalmologist’s report
The difference between the two documents is the starting point. The ordinary eye test, the Sehtest, is a measurement of visual acuity carried out by an optician or an ophthalmologist, and it simply records whether your vision reaches the required level, with or without glasses. The optician does not diagnose anything, and the certificate does not say why your vision is at a particular level. The ophthalmologist’s report, by contrast, is a full medical examination: the doctor measures your vision, examines the front and the back of the eye, tests the field of vision and colour vision, and gives a diagnosis and a prognosis, in other words, an opinion on whether the condition is stable, whether it is likely to get worse, and whether it affects your ability to drive safely.
In practice, the simple test is enough for the overwhelming majority of applicants, and the report is the exception. The authority only orders it when there is a reason to doubt that the simple test tells the whole story, and that reason is usually written in the letter you receive. The report is always ordered by the authority, not by you, and it is addressed to the authority, not to you, although you are entitled to see it. The cost is usually paid by you, and the report must be submitted within the deadline stated in the letter, which is usually a few weeks to a few months.
When the authority orders a report
There are several situations in which the driving licence authority orders an ophthalmologist’s report. The most common is a failed eye test in which the optician found something unusual, such as a large difference between the two eyes, a very poor result that glasses do not correct, or a visible change in the eye itself. In those cases the authority wants to know whether the problem is a simple refractive error, which glasses can fix, or a disease, which may need treatment and may affect the fitness to drive. A second common situation is a known eye disease, such as glaucoma, macular degeneration, diabetic retinopathy or a cataract, where the authority needs a medical opinion on the current state of the disease and its expected course.
Other situations include an application after an accident or an illness that has affected the eyes, a professional licence where the standards are stricter, such as a lorry or bus licence, and a case where only one eye sees well, because the authority then needs to know about the field of vision and the ability to judge distances. Our guide to the rules when one eye is weaker than the other covers that last situation in detail. The authority may also order a report if you have told it about an eye condition yourself, which is always the right thing to do, because hiding a condition is far worse than declaring it.
What the report contains
An ophthalmologist’s report is a thorough document, and it covers far more than the simple eye test. It records the visual acuity of each eye separately and of both eyes together, with and without correction, the field of vision, which is the area you can see without moving your eyes, colour vision, and in many cases twilight vision and glare sensitivity, which matter for driving at night. The doctor also examines the eyes with a slit lamp, looks at the retina, measures the pressure inside the eye, and notes any disease or change, so that the authority can see the whole picture rather than a single number.
Equally important is the doctor’s opinion, which is the part the authority reads most carefully. The doctor states whether you are fit to drive, whether you are fit only with conditions, such as wearing glasses or not driving at night, or whether you are not fit to drive at the present time. The doctor also gives a prognosis: whether the condition is stable, whether it is likely to worsen, and when the next examination should take place. That prognosis is often what decides the length of the licence, because a condition that is stable may lead to a normal licence, while a condition that is expected to worsen may lead to a licence that is limited in time.
How the process works
The process starts with a letter from the driving licence authority, and the first thing to do is to read it carefully. The letter says which kind of report is needed, which questions the doctor must answer, and the deadline by which the report must be submitted. It also says whether you may choose the ophthalmologist yourself or whether the authority has appointed one, and that is an important difference: in some cases you are free to choose any ophthalmologist, and in others the authority names a specific doctor or a list of approved doctors. If the letter does not make this clear, call the authority and ask before you book, because a report from the wrong doctor may not be accepted.
At the appointment, the examination is thorough and takes considerably longer than a simple eye test, usually between thirty and sixty minutes. The doctor will ask about your medical history, any eye conditions, medication and previous eye operations, and will then carry out the examinations described above. The report is usually sent directly to the authority by the doctor, although some doctors give it to you to submit yourself, and in either case you should ask for a copy for your own records. If the report is sent directly, the authority will contact you when it has been received and assessed, and that assessment can take a few weeks.
Costs and waiting times
An ophthalmologist’s report costs considerably more than a simple eye test, because it involves a full medical examination and a written opinion. As a rule, you should expect a fee of between one hundred and three hundred euros, depending on the scope of the examination and the region, and in complicated cases it can be more. The fee is usually paid by you, the applicant, and it is not covered by health insurance, because it is an examination requested by an authority rather than a medical treatment. Ask the practice for the fee in advance, and ask whether it includes the written report, so that there are no surprises.
The waiting time for an appointment is the other thing to plan for. Ophthalmologists are often booked out for several weeks, and the examination itself can take an hour, so you should book as soon as you receive the letter. If the deadline is short and no appointment is available, tell the authority and ask for an extension, showing the appointment confirmation as proof, because the authority is usually willing to extend the deadline when the delay is not your fault. Our guide to the eye test at the optician covers the much cheaper and quicker alternative for the ordinary application, which is the route most people take and the one that avoids the report altogether when the eyes are healthy.
If the report is unfavourable
A report that says you are not fit to drive, or fit only under conditions, is not necessarily the end of the application, and it is worth reading it carefully before deciding what to do. Often the restriction is a simple one, such as wearing glasses, not driving at night, or a licence limited in time with a repeat examination in a few years, and those conditions are manageable. If the problem is a condition that can be treated, such as a cataract, the doctor will say so, and the application can usually proceed after the treatment, with a new examination to confirm the improvement.
If you disagree with the report, you have options. You can ask the authority for a second opinion from another ophthalmologist, and you can also submit additional medical evidence, such as a report from your own eye doctor, although the authority is not obliged to accept it. In a serious case, you can appeal the authority’s decision through the administrative courts, but that is expensive and slow, so it is usually better to start with the medical route: get the treatment, get a new examination, and submit the new report. Whatever you do, do not drive without a valid licence, because the consequences of doing so are far worse than the delay.
When is an ophthalmologist’s report required: the cases that surprise people
Some of the cases in which a report is required surprise people, because the eye condition is not one they think of as serious. A squint, for example, can be the reason for a report, because the authority needs to know whether the two eyes work together and whether the field of vision is complete, and a squint that has been there since childhood is still a question the authority will ask. A lazy eye, amblyopia, is another: one eye may see perfectly and the other very little, and the authority needs a medical opinion on whether the good eye alone is enough for the licence, and whether the condition is stable. Neither of these is a reason to be refused, but both are reasons for a proper medical opinion, and the report is the way the authority gets it.
Another case that surprises people is a change after an operation. If you have had laser surgery, or a cataract operation, or an operation on the retina, the authority may ask for a report to confirm that the eye has healed and that the vision is stable, even if the operation was a success. The reason is that the authority needs to know the result, not the intention, and the only way to know the result is a medical examination. The report will usually be favourable, especially if the operation has improved the vision, but it must be obtained before the licence is issued, and the time it takes is worth planning for, because the appointment with the ophthalmologist can take several weeks to arrange.
A third surprise is the case of a medication that affects the eyes. Some medicines, such as certain drugs for blood pressure or for allergies, can cause dry eyes or blurred vision, and the authority may ask for a report to confirm that the medication does not affect the fitness to drive. If you take any regular medication, tell the doctor, and tell the authority, because a condition that is declared can be examined, while a condition that is hidden can only cause trouble later. The report in such a case is usually straightforward: the doctor confirms the medication and the vision, and the authority proceeds, often without any further questions.
Frequently Asked Questions
Does every failed eye test need an ophthalmologist’s report? No. Most failed tests are fixed with new glasses and a retest at the optician. A report is only ordered when the authority has a reason to doubt that the simple test tells the whole story, such as a disease or a very unusual result.
Can I choose the ophthalmologist myself? It depends on the letter from the authority. In some cases you may choose any ophthalmologist, in others the authority names one. Read the letter carefully before booking.
How long is the report valid? The report is usually accepted for a limited time after it is issued, often a few months, and the authority’s deadline governs. Submit it promptly once it is ready.
Who pays for the report? As a rule the applicant pays. The fee is usually between one hundred and three hundred euros, and health insurance does not normally cover it.
Can I choose which ophthalmologist writes the report? It depends on the letter from the authority. In some cases you may choose any ophthalmologist, and in others the authority names a specific doctor. Read the letter carefully before you book, because a report from the wrong doctor may not be accepted.
How long does the report take to reach the authority? The doctor usually sends it directly, and it arrives within a few days of the examination. The authority then needs a few weeks to assess it, so you should allow at least a month from the appointment to the decision, and more if the case is complicated.
Conclusion
An ophthalmologist’s report is required when the driving licence authority needs more than a simple measurement of your vision: when there is a disease, a very unusual result, or a question about your fitness to drive that only a medical opinion can answer. It is a thorough examination, it costs more and it takes longer than the ordinary eye test, but it is also the document that can clear the way for your licence when the simple test cannot.
If you receive a letter asking for a report, read it carefully, book the appointment immediately, and keep the authority informed about the deadline. Most reports lead to a licence, often with a simple condition such as wearing glasses, and the report is then a step on the way to driving, not a barrier.