The Ophthalmologist’s Report: Contents, Costs and Procedure

The ophthalmologist’s report: what does it contain, what does it cost, and how does the procedure work? If you have been told that you need a report from an ophthalmologist, the eye doctor, for your driving licence, you may be wondering why a simple eye test at the optician was not enough, what the doctor will actually do, and how much the whole thing will cost. The short answer is that the ophthalmologist’s report is a detailed medical document, and it is needed when your vision, or your eye health, is more complicated than the simple eye test can cover. It is the document that the licensing office uses when it needs to be sure that you are safe to drive, not just that you can read the letters on a chart.

Most people never need an ophthalmologist’s report. The simple eye test at the optician, which takes five minutes and costs a few euros, is enough for a car licence, for most people. But if you fail part of the eye test, if you have a medical condition that affects your eyes, if you are applying for a lorry or bus licence, or if you are over a certain age and your licence needs to be renewed with a medical examination, the licensing office will ask for a report from an ophthalmologist. That report is more detailed, it takes longer, and it costs more, but it is also more thorough, and it can be the difference between getting your licence and being refused one.

This guide explains the ophthalmologist’s report in full: when you need one and when you do not, what the examination involves, what the report contains, what it costs, and how the procedure works from the first phone call to the day you hand the report to the licensing office. It also explains the difference between the ophthalmologist and the optician, so that you know which one you need and why. For a general comparison, read our article on ophthalmologist or optician: where to take your eye test.

When you need an ophthalmologist’s report

There are several common situations in which you will need an ophthalmologist’s report. The first is that you have failed part of the eye test at the optician. If your visual acuity is below the limit for your licence class, even with glasses or contact lenses, or if your visual field is restricted, or if you have failed the colour vision test, the optician will not be able to give you a certificate, and they will refer you to an ophthalmologist, who can investigate the reason and write a report. The licensing office will then decide, on the basis of that report, whether you can drive, and whether any restriction is needed.

The second situation is that you have a medical condition that affects your eyes. Diabetes, for example, can damage the retina, and the licensing office will want to know that your retina is healthy before it grants or renews a licence. A cataract, glaucoma, macular degeneration, or a problem with the optic nerve are all conditions that can affect your ability to drive, and they all need to be assessed by an ophthalmologist. If you have one of these conditions, tell the licensing office and your driving school, because they will need a report, and because the earlier you get it, the less it will delay your application.

The third situation is the professional licence. For classes C and D, lorry and bus, the eye test is more detailed than the car eye test, and it is usually done by an ophthalmologist rather than an optician, because the professional test includes a visual field examination, a colour vision test, and a check for eye diseases, all of which are medical procedures. The same is true for the renewal of a professional licence every five years, when a medical examination is required, and the ophthalmologist’s report is part of that examination. If you are applying for a professional licence, budget for the ophthalmologist’s report as part of the cost of the course. For the details of the professional test, read our guide to the eye test for lorry and bus licences.

What the examination involves

The ophthalmologist’s examination is much more thorough than the eye test at the optician, and it takes longer, usually between 30 and 60 minutes. It starts with a conversation about your medical history, your medication, your family history of eye disease, and the licence class you are applying for. The doctor will want to know what you need the report for, because the requirements for a car licence are different from the requirements for a lorry licence, and the report must cover the right ones. Bring your driving licence eye test certificate if you have one, and bring your glasses or contact lenses, and your current prescription.

The examination itself covers your visual acuity, which is measured in the same way as at the optician, with an eye chart, first without correction and then with your glasses or contact lenses. It also covers your visual field, which is measured with a perimeter, a machine that flashes small lights at the edges of your vision while you look straight ahead, to check that your peripheral vision is wide enough. It covers your colour vision, with the Ishihara plates and sometimes with a practical test using coloured lights. And it covers the health of your eyes, with a slit lamp examination of the front of the eye, and an examination of the retina at the back of the eye, often with drops that dilate your pupils so that the doctor can see the retina clearly.

One practical point is important: the drops that dilate your pupils will make your vision blurry, and they will make you sensitive to light, for several hours after the examination, and you will not be able to drive. Do not drive yourself to the appointment, and do not plan to drive afterwards. Ask a friend or family member to drive you, or take public transport, and bring sunglasses, because the light will be uncomfortable. The doctor will tell you when your vision will be back to normal, which is usually within four to six hours, but it can be longer. Plan your day around that, and do not book the examination on a day when you need to drive.

What the report contains

The report itself is usually two to four pages long, and it follows a standard format that the licensing office expects. It starts with your personal details, the date of the examination, and the reason for the report, which is usually the licence class you are applying for, or the medical condition that needs to be assessed. Then it gives the results of the examination, in numbers: your visual acuity for each eye, with and without correction, your binocular visual acuity, your visual field, and your colour vision. Those numbers are the core of the report, and they are the numbers that the licensing office will compare with the legal limits for your licence class.

After the numbers, the report gives the doctor’s findings on the health of your eyes. It will say whether you have a cataract, and if so how advanced it is; whether your retina is healthy; whether there are signs of glaucoma or macular degeneration; and whether there is any other condition that affects your vision. The doctor will also say whether the condition is stable, whether it is getting worse, and whether it is likely to get worse in the future. That last point matters, because the licensing office needs to know whether your vision will still be good enough in five years, when your licence is renewed, not just whether it is good enough today.

Finally, the report gives the doctor’s recommendation. That is the most important part, because it is the doctor’s professional judgement on whether you are fit to drive, and whether any restriction is needed. The recommendation might be that you are fit to drive without restriction, that you are fit to drive with glasses or contact lenses, that you are fit to drive only in daylight, or that you are fit to drive only with a particular type of vehicle. Or the recommendation might be that you are not fit to drive, in which case the report will explain why, and what treatment might make you fit in the future. The licensing office almost always follows the doctor’s recommendation, so it is worth reading it carefully and asking the doctor to explain it if anything is unclear.

How much does the report cost?

The cost of an ophthalmologist’s report varies, but it is usually between 50 and 150 euros, depending on the practice and on how detailed the report needs to be. A simple report for a car licence, with a visual acuity test, a visual field test and a colour vision test, is at the lower end of that range. A more detailed report for a professional licence, or for a licence renewal after an eye disease, can be at the higher end, because it involves more tests and more of the doctor’s time. The eye examination itself is usually covered by your health insurance if you have a medical reason for it, but the report for a driving licence is a private service, a so called individual health service, and you will usually have to pay for it yourself.

It is worth asking about the price before you book the appointment, so that there are no surprises. Call the practice, tell them that you need an ophthalmologist’s report for your driving licence, and ask what it will cost, and whether the price includes the examination or whether the examination is charged separately. Some practices charge a flat fee for the examination and the report together, while others charge for the examination and then add a fee for the written report. If the price seems high, you can call two or three practices and compare, because the price can vary by 50 euros or more between practices in the same town.

There are also some costs to think about beyond the report itself. If the doctor finds a cataract, or another condition that needs treatment, the treatment will usually be covered by your health insurance, but it can take time, and it can delay your licence. If you need new glasses or contact lenses, those are an extra cost, although a basic pair of glasses is not expensive, and it is worth having one even if you normally wear contact lenses. And if you have to travel to the ophthalmologist, remember that you cannot drive home after the dilating drops, so you may need to pay for public transport or for a taxi, or ask someone to drive you. Those are small costs, but they are worth planning for.

How to book the appointment and what to bring

Booking an ophthalmologist appointment is simple, but it can take a while, because waiting times for eye doctors in Germany are often several weeks, and in some areas several months. If you need the report urgently, tell the practice why when you call, and ask whether there is a sooner appointment, or whether they can put you on a waiting list for a cancellation. Some practices offer a special appointment for driving licence reports, which is quicker, and some offer a private appointment that costs more but is available sooner. It is worth asking, especially if your driving test is already booked.

When you go to the appointment, bring everything the doctor might need. That includes your identity card, your health insurance card, a list of your medication and any medical conditions, your glasses or contact lenses and your current prescription, and any previous eye test results, including the certificate from the optician if you have one. If you have a referral letter from the optician or from the licensing office, bring that as well, because it tells the doctor exactly what the report needs to cover. The more information the doctor has, the more complete the report will be, and the less likely it is that the licensing office will ask for more information.

It is also a good idea to bring someone with you, not only because you will not be able to drive home afterwards, but also because it can help to have another person there to hear what the doctor says. The doctor will explain the results and the recommendation, and it can be a lot to take in, especially if the news is not what you hoped for. A second pair of ears can help, and the person who drives you home can also ask questions that you might forget to ask. If you are nervous, tell the doctor, and ask them to explain things slowly; they deal with nervous patients every day, and they are used to it.

What happens after the report

After the examination, the doctor will usually write the report within a few days, and you will either collect it from the practice or have it sent to you by post. Some practices send the report directly to the licensing office, but most give it to you, and you take it to the licensing office yourself, together with the rest of your application. Check the report when you get it, and make sure that your name, your date of birth, and the licence class are correct, and that the doctor’s recommendation is clear. If anything is wrong, contact the practice straight away, because a mistake on the report can delay your application.

Once the licensing office has the report, it will decide whether to grant your licence, to grant it with a restriction, or to refuse it. That decision usually takes one to three weeks, and the office will write to you with the result. If the licence is granted with a restriction, the restriction will be recorded on the licence itself, in the form of a code number, and you must follow it. If the licence is refused, the letter will explain why, and what you can do, which may include treatment, a re-examination after a period of time, or an appeal. For more on the eye test at the ophthalmologist, read our guide to the eye test at the ophthalmologist.

Frequently Asked Questions

When do I need an ophthalmologist’s report?
When you have failed part of the eye test, when you have a medical condition that affects your eyes, when you are applying for a professional licence, or when the licensing office asks for one.

How much does the report cost?
Usually between 50 and 150 euros, depending on the practice and how detailed the report needs to be. The report itself is a private service, so you will usually pay for it yourself.

How long does the examination take?
Usually 30 to 60 minutes, including the conversation, the visual acuity test, the visual field test, the colour vision test, and the examination of the front and back of the eye.

Can I drive home after the examination?
No. The drops that dilate your pupils will make your vision blurry and sensitive to light for several hours. Ask someone to drive you, or take public transport, and bring sunglasses.

How long is the report valid?
The report is usually accepted for up to two years, but it is best to hand it in as soon as you get it, and to ask the licensing office how long it will be accepted, because the exact rule can depend on the office and on the licence class.

Conclusion

The ophthalmologist’s report is a detailed medical document, and it is needed when your vision or your eye health is more complicated than the simple eye test can cover. It tells the licensing office what your visual acuity is, what your visual field is, what your colour vision is, and whether your eyes are healthy, and it gives the doctor’s recommendation on whether you are fit to drive, and whether any restriction is needed. It costs between 50 and 150 euros, it takes 30 to 60 minutes, and it is worth every euro, because it is the thorough, professional assessment that the licensing office needs to make a fair decision.

If you have been told that you need an ophthalmologist’s report, do not put it off. Book the appointment, bring your documents, and be honest about your medical history and your vision, so that the report is accurate and complete. With a good report, and the right correction, most people get the licence they want, and they get it on the basis of a proper medical assessment, which is the best foundation for safe driving.