The SAAQ sends this two-page report to a licence holder when their vision must be checked against Quebec's driver health regulation, and an optometrist or ophthalmologist completes it. It records Snellen acuity with and without correction, monocular vision, binocular field anomalies, severe colour vision deficiency, diplopia within the central 40 degrees and listed eye conditions, with a recommendation on night driving.
The examinee signs an authorization at the top; the ophthalmologist or optometrist completes sections 1 to 7 and signs with their licence number.
Download the current version from the source each time; forms change without notice.
Eye Examination Report – Ophthalmology/Optometry – Eye Health – Fitness to Drive (5)
Rapport d'examen visuel en ophtalmologie ou en optométrie – Santé visuelle – Aptitude à conduire
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Yes. The form covers ophthalmology and optometry, and the examining professional checks either ophthalmologist or optometrist and gives their professional licence number. Diplopia, colour vision, monocular vision and eye conditions such as glaucoma, macular degeneration or diabetic retinopathy are all reported by the same examiner.
When there is a binocular visual field anomaly, the SAAQ needs binocular field charts signed by the specialist showing measurement up to 160 degrees with the Goldmann III/4e technique with scotoma screening, the Esterman technique or an equivalent recognized technique, done with driving lenses and both eyes open.
The SAAQ sends the form when a driver's vision needs assessment. Its FAQ adds that drivers turning 75 now complete a self-declaration, after which the SAAQ may still request a vision report, while drivers aged 80 and every two years after must provide medical and vision reports.