Visual field defects after epilepsy surgery. Implications for driving license tenure

Epilepsy surgery is an effective and established therapy in medically uncontrollable seizure disorders. In the course of such operations lesions of the visual pathway are often unavoidable. The resultant visual field defects can conflict with the legal requirements for a driving license. In this single center trial Goldmann perimetric findings in 135 temporal lobe epilepsy surgery procedures were analyzed retrospectively. The data were reviewed with respect to current and former German legal requirements for a driving license. Of the surgical procedures 64 % resulted in visual field defects, 50 % of the postoperative visual field findings did not comply with the legal requirements for a driving license and 56 % did not comply with those for a heavy goods vehicle driving license. A considerable proportion of the epilepsy surgery procedures examined in this study resulted in visual field defects that did not comply with the German legal requirements for driving vehicles. In all cases defects in the center of the visual field proved pivotal.