Eye examinations for disability certificates, driver’s licenses, and pensions

Key points at a glance

Main points of this topic

• Even with the same eye exam, the purpose differs for a disability certificate, driver’s license, and pension.
• Visual acuity is, in principle, often assessed as best-corrected visual acuity¹⁾²⁾⁶⁾.
• Visual field testing is especially important for disability certificates and disability pensions⁵⁾⁶⁾.
• Depth perception is important for large-vehicle licenses³⁾.
• In pension medical certificates, a visual field chart must be attached⁵⁾.
• Results from Goldmann perimetry and automated perimetry cannot be mixed⁵⁾⁶⁾.

1. What are eye examinations for applications?

Visual acuity and visual field tests done in ophthalmology are used not only for treatment, but also as documents for public-system determinations. Typical systems are disability certificates, driver’s licenses, and disability pensions.

However, even for the same visual acuity, what is assessed differs by system. For licenses, the focus is driving fitness; for disability certificates, disability recognition; and for pensions, disability recognition based on the impact on work and daily life.

2. Relationship between major tests and systems

Visual acuity

Main systems: certificate, license, and pension.

Points to check: values for both eyes and one eye, whether correction is used, and the threshold for each system.

Note: For the certificate and pension, best-corrected visual acuity is the basic standard¹⁾²⁾⁶⁾.

Visual field

Main systems: certificate, pension.

Points to check: peripheral visual field, central visual field, number of points seen, and attachment of the visual field chart.

Note: With an automated visual field test, the Esterman and 10-2 results are important⁵⁾⁶⁾.

Depth perception

Main systems: large, medium, semi-medium, towing, and second-class licenses.

Points to check: depth perception by the three-bar method.

Note: This is usually not a required item for ordinary license categories³⁾.

The main points by system are as follows.

System	Main items examined	Purpose
Handbook	Visual acuity and visual field	Disability certification
License	Visual acuity, visual field, and stereopsis	Driving fitness
Pension	Visual acuity, visual field, and medical certificate	Disability certification

Q Is the depth perception test something everyone takes?

A

No. The depth perception test is mainly an issue for large, medium, semi-medium, towing, and class 2 licenses. For regular licenses, visual acuity standards are usually the main focus³⁾.

3. What to check before the examination

If you are being seen with a system application in mind, the following checks are useful.

• Clarify the purpose: First say whether the test is for a handbook, a license, or a pension.
• Bring your correction: Bring your usual glasses, contact lenses, and a spare pair of glasses.
• Form availability: If there is a required form, such as a pension medical certificate, check it in advance⁴⁾⁵⁾.
• Changes in symptoms: For conditions whose vision changes from day to day, your condition on the day of the test can affect the result.
• Check existing data: If you have past visual field charts or surgery records, they can help with comparison.

What to mention when making the appointment

When you say, ‘for a disability pension medical certificate,’ ‘to discuss a physical disability handbook,’ or ‘to check vision before renewing my license,’ it is easier to be guided to the right exam slot and what to bring.

Q If you wear contact lenses, should you remove them for the test?

A

In many systems, corrected visual acuity rather than uncorrected visual acuity is the important measure. It is safest not to remove your correction on your own; tell the medical facility about your usual correction conditions and follow their instructions¹⁾²⁾⁶⁾.

4. Examination methods by system

Physical Disability Certificate

For the certificate, vision is judged by best-corrected visual acuity⁶⁾. Visual fields are measured with a Goldmann perimeter or an automated perimeter⁶⁾. On automated perimetry, the binocular Esterman test, 120 points, and the 10-2 program, 68 points, are the standard criteria⁶⁾.

Driver’s license

For licenses, visual acuity thresholds are set for each license category³⁾. For monocular vision or low vision in one eye, visual field requirements are added. For large vehicles and similar categories, depth perception testing by the three-prism method is required³⁾.

Disability pension

For pensions, the eye disability medical certificate must include visual acuity, visual fields, the date of the current findings, activities of daily living, work ability, and other items⁴⁾⁵⁾. If there is a visual field disorder, attach a visual field chart for a Goldmann perimeter, or the Esterman and 10-2 results for automated perimetry⁵⁾.

5. Standard visit flow

A visit before applying for a system is easier to understand in the following flow.

Step	Content	Notes
1	Convey the purpose	Clearly state the program name
2	Basic examination	Mainly visual acuity
3	Additional tests as needed	Visual field and depth perception
4	Document review	Forms and attachments
5	Pre-submission check	Consistency of values

Because the required examinations differ by program, there are times when it is hard for one exam to cover everything. In particular, for the medical certificate for pension and disability certificate applications, it is important to check the visual field chart format and the way the judgment is made⁵⁾⁶⁾.

Q Can the same test result be used as is for the disability certificate and pension?

A

It can be used in some cases, but it is not always the same. Because the assessment criteria, required attachments, and medical certificate format differ, you need to check the conditions required by each submission destination⁴⁾⁵⁾⁶⁾.

6. How to read test results

When applying under these programs, understanding what the numbers mean can help prevent confusion.

• Corrected visual acuity: vision measured when glasses or contact lenses are used to give the best possible sight¹⁾²⁾⁶⁾.
• Binocular and monocular: for licenses, both the binocular standard and each-eye standard are checked³⁾.
• Peripheral visual field: looks at how wide the area you can see is. Important for the disability certificate and pension application⁵⁾⁶⁾.
• Central visual field: looks at vision around the central 10 degrees. Important when evaluating visual field constriction and scotomas⁵⁾⁶⁾.
• Visible points: This is a numerical measure of how many points can be seen on an automated visual field test⁵⁾⁶⁾.
• Depth perception: This is the accuracy of seeing depth, and it is different from ordinary visual acuity³⁾.

It is important not to mix results

Results from Goldman perimetry and automated perimetry cannot be mixed in a single judgment⁵⁾⁶⁾. To avoid having to resubmit for a benefits application, you need to clearly state which method was used for the evaluation.

Q When is a visual field chart needed?

A

When applying for a disability handbook or disability pension based on a visual field disorder. For pension applications, if Goldman perimetry was used, a visual field chart is required; if automated perimetry was used, Esterman and 10-2 results must be attached⁵⁾.

7. Points to check before submission

Before submitting, review the following points.

• Is the program name correct?: Avoid using the wrong form for each submission destination.
• Is the date of current condition recent?: Old data may require a repeat examination.
• Are all required attachments included?: Visual field chart, identity verification, photos, and so on.
• Are the correction conditions clearly stated?: Avoid confusion about whether the test was done without correction or with correction.
• Are the numbers consistent?: Check that the diagnosis, visual acuity, and visual field findings do not differ drastically.

A final check before submission is recommended

In administrative applications, the issue may be not the examination itself but whether the results are complete in the required format. Before submitting, please check the latest required documents with both the medical institution and the submission destination.

8. References

1. 日本眼科医会ほか. 成人の視力検査および眼鏡処方に関する手引き（緒言・臨床編） [Internet]. 2025.

2. 日本眼科医会ほか. 成人の視力検査および眼鏡処方に関する手引き（基礎編） [Internet]. 2025.

3. 警視庁. 適性試験の合格基準 [Internet]. Available from: https://www.keishicho.metro.tokyo.lg.jp/menkyo/menkyo/annai/other/tekisei03.html

4. 日本年金機構. 診断書（眼の障害用） [Internet]. Available from: https://www.nenkin.go.jp/shinsei/jukyu/shougai/shindansho/20140421-22.files/01-1.pdf

5. 日本年金機構. 障害基礎年金・障害厚生年金の診断書作成の留意事項《眼の障害》 [Internet]. Available from: https://www.nenkin.go.jp/shinsei/jukyu/shougai/shindansho/20140421-22.files/01-3.pdf

6. 厚生労働省. 身体障害者障害程度等級表の解説（身体障害認定基準）について [Internet]. Available from: https://www.mhlw.go.jp/content/000615256.pdf