Strategic framework for vision screening standards for driving in South Africa

Background: Driving is a visually demanding task, and in South Africa, gaps in driver licensing policies, particularly the limited integration of optometrists, Driver Licensing Testing Centres, and systematic visual assessments, persist despite clear evidence linking vision and road safety. Aim: This study aimed to develop an evidence-based framework to strengthen South Africa’s vision screening standards for driving, integrating clinical, regulatory, and public health perspectives through empirical research and policy analysis. Method: A mixed-methods approach was used, comprising a systematic review and meta-analysis, stakeholder interviews with policy analysis, a quantitative study on visual function and road traffic accidents, and an online survey of optometrists’ practices. Findings were synthesised through thematic analysis and methodological triangulation to identify gaps and develop an integrated framework for strengthening vision screening in South Africa’s driver licensing system. Results: The resulting framework comprises five strategic pillars: (1) expanded screening criteria, (2) policy alignment, (3) stakeholder engagement, (4) infrastructure and technology enhancement, and (5) public awareness, underpinned by continuous monitoring and evaluation to ensure national scalability. It supports standardised, evidence-based vision screening, advancing early detection of visual impairments and contributing to South Africa’s road safety goals. Conclusion: The proposed framework enhances the relevance and consistency of vision screening for drivers by standardising protocols, addressing systemic and clinical gaps, and introducing evidence-based assessments aligned with licensing regulations to better capture visual functions critical to driving performance. Contribution: This study provides a strategic foundation for national policy and legislative reform, enabling scalable adoption of standardised, evidence-based vision screening programmes, strengthening driver fitness assessment, and enhancing road safety in South Africa.