Cataract and driving: can you drive, and when can you drive again?

5/10

minimum binocular acuity, with correction, to reconcile cataract and driving in France

÷ 2

crashes among patients who had cataract surgery, compared with those who did not, over 4 to 6 years of follow-up

80 %

of patients troubled by glare drive at night again after surgery, against 41 % before

Cataract and driving: what the law requires

Cataract is on the official list of medical conditions that can affect fitness to drive, but it carries no automatic ban. What counts is the vision you actually have, measured with your glasses or contact lenses. In France, the decree of 28 March 2022 sets three requirements for car and motorcycle licences.

Visual acuity of at least 5/10

Measured with both eyes open, with correction. If one eye no longer sees, the other must reach 5/10 on its own. An early cataract usually leaves acuity well above this threshold; an advanced cataract pushes it below, sometimes without the driver noticing, because the decline is slow and painless.

A visual field of at least 120°

The horizontal binocular field must extend 50° to each side and 20° upwards and downwards, with no defect within the central 20°. Cataract affects the lens, not the retina, so it generally spares the visual field: this criterion mainly concerns glaucoma and retinal diseases.

Adequate night vision

The text sets no figure, but it provides that a significant impairment of night vision remains compatible with the licence under the restriction “daytime driving only”. That is exactly where cataract strikes: it scatters the light of headlights long before it lowers acuity.

For lorry, bus and taxi licences the requirements are stricter: 8/10 in the better eye, 1/10 in the other, a 160° field, and any confirmed impairment of night vision or contrast sensitivity is incompatible. A professional driver with a cataract is therefore affected earlier, and surgery is discussed sooner.

Cataract and driving: the warning signs behind the wheel

Between cataract and driving, the first conflict is not about reading road signs but about light. A clouding lens scatters light beams instead of transmitting them, and lowers contrast sensitivity. Four situations keep coming up in patients’ accounts.

Dazzling headlights

Oncoming vehicles throw halos or streaks of light, and it takes a second or two to “recover”. This is the earliest and most specific sign.

Dusk and rain

In low light or on a wet road, contrasts fade: road markings, a pedestrian in dark clothes, the edge of the road. Driving becomes tiring, then stressful.

Road signs read too late

You read signs and number plates closer than you used to, or you rely on the satnav rather than the signage. A change of glasses makes no difference, or not for long.

Avoidance

You give up night journeys, motorways, unfamiliar routes. This spontaneous adjustment is wise, but it signals that the cataract is already limiting your independence.

These signs justify a consultation and an assessment, even if the last acuity measurement seemed reassuring: the letter chart in the consulting room measures high-contrast vision in full light, that is, in the very conditions where cataract bothers you least.

Dedicated page—cataracte.fr Cataract: symptoms, progression, diagnosis

Driving until the operation: the rules of caution

A cataract forms over months or years, and the operation is not an emergency. During this period, cataract and driving remain compatible if vision meets the requirements, provided you adapt your habits to what the eye can still do.

Prefer daylight and familiar routes

A cataract is little trouble in full daylight on a familiar route. Leaving night, rain and long unfamiliar journeys to another driver is the most effective decision, and the one the regulations themselves provide for with the restriction “daytime driving only”.

Up-to-date glasses, with an anti-reflective coating

A cataract often changes refraction: it makes the eye more short-sighted. An updated prescription sometimes recovers a line or two of acuity, and an anti-reflective coating reduces the glare of headlights. It cures nothing, but it extends safe driving by a few months.

A sun visor and a clean windscreen

A scratched or dirty windscreen multiplies the light scatter that the clouded lens already produces. Category 2 or 3 sunglasses for daytime driving, never at night, soften the glare of a low sun.

When these adjustments are no longer enough, or when corrected acuity in the better eye falls below 5/10, driving must stop until the operation. Between cataract and driving, it is in fact driving that most often decides the date of surgery: for many patients, the need to drive is what tips a cataract “under observation” into a cataract “to be operated on”.

Dedicated page—cataracte.fr Untreated cataract: what happens if you wait?

After cataract surgery: when can you drive again?

When it comes to cataract and driving, this is the question almost every patient asks. The answer comes down to one absolute rule and two stages.

On the day of surgery: never

The operated eye is dilated by the drops for several hours, it is protected by a shield fitted by the surgeon, and sedation has often been given. You must be accompanied to get home, in a car driven by a relative, by taxi or by public transport. It is a condition of discharge from the clinic. The shield is removed the next morning, then put back each night for a week.

The following days: daytime driving

After a straightforward operation, vision in the operated eye is often already good the next day, at the post-operative check. Resuming daytime driving is then decided with the surgeon, generally within the following days, as soon as vision is sharp and stable and you feel comfortable. This is the typical case of the long-sighted or emmetropic patient, whose implant is calculated to see clearly at distance without glasses. Start with short, familiar journeys. The French health insurance reminds patients that driving is not advised until vision is satisfactory.

The following weeks: night driving

Halos around headlights, common in the first days, fade over the weeks as the cornea settles and the pupil returns to its usual size. With a monofocal implant, night driving most often resumes within the following days, at the same time as daytime driving. With a multifocal implant it can remain difficult for longer, even though the halos tend to fade with time. The final glasses are prescribed 4 weeks after surgery, after the last eye operated on if both are: until then, if a residual correction is needed to reach 5/10, a temporary pair is required.

Cataract and driving between the two operations: it is better to have had both eyes operated on before getting back behind the wheel. The biggest determinant is the target chosen with the surgeon. A short-sighted patient who is deliberately left short-sighted after surgery does not see clearly at distance without correction: he or she must usually wait for the glasses prescription, one month after the second eye. A long-sighted or emmetropic patient, whose implant is set for distance, can generally resume driving within the days following the first operation, in daylight and on familiar routes. Between the two eyes, the two images differ and the old pair of glasses no longer fits: caution is required, and the interval between the two operations is deliberately short, one to four weeks. After a complicated operation or combined retinal surgery, recovery is slower and the surgeon sets a specific delay.

Dedicated page—cataracte.fr Recovery after cataract surgery, day by day Further reading—docteurgozlan.fr Cataract: operate on one eye or both? How long between the two?

Cataract and driving: what the operation changes, in figures

The effect of cataract surgery on road safety has been measured directly, on real crashes and on a test circuit. The results all point the same way.

Half as many crashes

A cohort of 277 drivers aged 55 to 84 with cataract, followed for 4 to 6 years in the United States, compared those who had surgery with those who declined it: the rate of police-reported crashes was halved in the surgery group, after adjustment for age and mileage.

Minus 12.7 % at the scale of a population

In Western Australia, linking surgical and police records for 27,827 patients operated on in one eye only showed a 12.7 % drop in crashes in the year after surgery compared with the year before. The effect therefore exists from the first eye.

Driving back to normal

On a closed circuit, older drivers with bilateral cataract drove less well than controls of the same age. After surgery on both eyes, their performance matched that of the controls, alongside the return to normal of contrast sensitivity and glare tolerance.

The night regained

In patients who still saw 5/10 or better but complained of glare, contrast sensitivity measured under night conditions was abnormal before surgery and normal afterwards. Before the operation, 41 % of them still drove at night; afterwards, 80 %.

These data explain why, in the discussion of cataract and driving, the operation is not merely a comfort: for a driver who is struggling, it is a safety measure, for them and for others.

Dedicated page—cataracte.fr Cataract surgery, step by step

Cataract and driving: licence, approved doctor and insurance

In France, the car licence requires no periodic medical examination. The driver therefore carries the responsibility for his or her own vision. On cataract and driving, three practical rules.

No spontaneous declaration

A cataract does not have to be declared to the prefecture or to the insurer. On the other hand, if your vision no longer meets the legal requirements, you must stop driving, and an opinion from a doctor approved by the prefecture may be needed to rule on your fitness. This doctor cannot be your own GP; the visit costs €36, not reimbursed.

The insurance risk

According to service-public.fr, a driver responsible for an accident linked to a condition incompatible with driving, who has not undergone the medical check, is not covered by his or her insurance. Knowingly driving with acuity below 5/10 falls into this case.

After surgery: code 01

If your licence bears code “01”, driving with correction, and the implant now frees you from it, the code does not disappear by itself: a certificate from the ophthalmologist, then an opinion from the approved doctor, allow it to be removed. As long as it appears, driving without glasses is an offence, even with excellent eyesight.

For professional drivers, the medical examination is compulsory and periodic: a cataract is detected early, and surgery is often the condition for continuing to work.

Lens implants and night driving: a choice to make before surgery

The type of intraocular lens has a direct consequence for night driving. It is one of the questions to raise at the pre-operative assessment, especially if you drive a lot at night or for a living. Cataract and driving at night: three scenarios.

Monofocal implant

This is the reference choice for the driver: a single sharp image at distance, the minimum of halos and glare, good-quality night vision. It requires glasses for reading, which is no handicap at the wheel.

Multifocal or extended depth of focus implant

It reduces dependence on glasses, but at the cost of more frequent halos and glare around light sources, documented by the Cochrane review comparing these implants with monofocals. The halos tend to fade over the weeks and most patients get used to them; but night driving can remain difficult for longer than with a monofocal, and a regular night driver, a chauffeur or a lorry driver must be told before choosing.

Toric implant

By correcting astigmatism, it improves distance sharpness without glasses, hence the reading of road signs and the perception of contrasts, with no adverse effect on night vision.

Dedicated page—cataracte.fr Intraocular lens implants: monofocal, toric, EDOF, multifocal Further reading—docteurgozlan.fr AMD and driving: when the retina is the cause

Frequently asked questions about cataract and driving

Yes: cataract and driving remain compatible as long as vision meets the legal requirements, at least 5/10 in binocular vision with correction, and a horizontal visual field of at least 120°. A cataract does not forbid driving in itself, but it first degrades night vision and resistance to glare, often before the acuity measured in the consulting room drops. Below 5/10 in the better eye, even corrected, driving must be ruled out; the ophthalmologist tells you where you stand.

Never on the day of surgery: the eye is dilated, protected by a shield, and sedation may have been given. After that, resumption depends on visual recovery and on the advice given at the post-operative check. For a straightforward operation with an implant set for distance, driving often resumes within the following days, by day and by night; with a multifocal implant, night driving can remain difficult for longer, until the halos fade. A patient left short-sighted usually waits for his or her glasses, one month after the second eye.

It is better to have had both eyes operated on. Between the two operations, the operated eye and the unoperated eye see differently, depth perception is less reliable and the old pair of glasses no longer fits. It all depends on the target: a long-sighted or emmetropic patient, whose implant is set for distance, can resume in daylight on familiar routes as soon as the first eye sees clearly; a patient left short-sighted must wait for glasses, one month after the second eye.

On cataract and driving, there is no spontaneous declaration to the prefecture. On the other hand, every driver must make sure that his or her vision meets the legal requirements, and consult a doctor approved by the prefecture if a condition on the official list concerns them. Driving while knowing that your vision is insufficient exposes you, in the event of an accident, to not being covered by your insurance.

Yes, and it has been measured. In an American cohort followed for 4 to 6 years, operated patients had half as many crashes as those who had declined surgery. A study covering a whole Australian population found a 12.7 % drop in police-reported crashes in the year after surgery on the first eye. Contrast sensitivity and glare tolerance return to normal.

Cataract and driving: can you drive, and when can you get back behind the wheel after surgery?