A method for examining the central visual field in eyesight tests for driving licences

The ARTO-perimeter® is a new, official device for examining the central visual field in accordance with the visual field requirement for a driving licence. The product is suitable for all health care professionals who perform eyesight tests for driving licences: general practitioners, public health nurses, eye specialists, optometrists, opticians. The perimeter is unique and easy to use as it is accessed via the screen of the examiner's personal computer. Click HERE to download a brochure on the ARTO-perimeter

Using the ARTO-perimeter does not require you to purchase any new, separate equipment that you must find a place for in your reception area.

Up until today, examining the central visual field for defects has been extremely difficult or downright impossible in an ordinary testing environment. ARTO-perimeter allows carrying out the test in any examination room. The visual field examinations for a driver's licence can now be carried out with excellent accuracy.

Examination method

The ARTO-perimeter is a protected PDF file. All you need for using it is the free Adobe Acrobat Reader software. The examination is carried out on the screen of the examiner's personal computer.

The examiner turns the screen towards the examined person and checks that the distance between the screen and the customer is correct. The correct examination distance can be easily measured using the calibration line on the front page of the perimeter. After this, the examiner displays the test pages.

The examined person keeps looking at a cross at the corner of the screen and explains how many test points (1, 2 or 3) he or she sees on each page. When the person's central visual field is faultless, he or she will give the correct answer on all test pages. If there are absolute visual field losses in the examined person's visual field, the person will give an inaccurate number of test points on one or more of the test pages. In this case, the person will not pass the test and must be referred to an eye specialist for further examination.

Visual field standards for a driving licence

An EU Directive lays down regulations on both the extent of the required horizontal visual field as well the presence of no defects in the up and down directions and the central field. Examining the central visual field for defects (a radius of 20 degrees for group R1 and 30 degrees for group R2) has proven to be most difficult. The ARTO Perimeter has been developed for performing the tests for this requirement.

The ARTO-perimeter allows detecting absolute defects in the central visual field with the accuracy determined in a recommendation issued by a Pan-European group of experts*. There are 24 test points for driving licence group R1 and 32 for driving licence group R2.

The ARTO-perimeter also allows examining the extent of the visual field to the up and down directions as required by the EU Directive. When the examined person sees all test pages accurately, the requirements set for the lack of defects in the horizontal visual field as well as extensions up and down are fulfilled. Finger perimeter is only needed for examining the lateral visual field.

*"…For this reason it is recommended to develop a 'traffic perimetry algorithm', analogous to the recommendations of the German Ophthalmological Society (1999). This should preferably comprise a sufficient number of test points within the area of interest. A sufficient number of those (e.g. 25) should be located in the central area of the visual field since this area is of particular importance for perception during driving and perception in general..." New standards for the visual functions of drivers. Report of the Eyesight Working Group , Brussels, May 2005, page 10.

Developing the ARTO-perimeter

The ARTO-perimeter was developed and created by optometrist Arto Hartikainen. The development work was launched due to a practical need. For years, Hartikainen had been performing tests for driving licences. As a result, he was well-aware of the shortcomings in examining the central visual field for faults. Although there was a requirement for no defects in the central visual field, no suitable method for examining this was available.

In October 2012, Maija Mäntyjärvi, Professor Emerita in ophthalmology at the University of Eastern Finland lectured on the new eyesight requirements for a driving licence at a supplementary training event for opticians. During her lecture, Mäntyjärvi pondered whether a device for testing the central visual field on a computer screen could be developed.

As soon as the training event ended, Arto Hartikainen started creating ideas for a suitable innovation. He familiarised himself with the graphics of computer screens, the domain of pixels and resolutions. At the same time, he started designing different alternatives for the test signs. In January 2013, three months after the lecture by Mäntyjärvi, Hartikainen had completed the first prototype of the ARTO-perimeter. In 2013, the perimeter was changed from its initial version to its final form with improved accuracy in many of its parts.

From the start, Hartikainen's goal has been to ensure the ease, reliability and, above all, possibility to introduce the product to any research unit with any computer. The final version of the ARTO-perimeter fulfils all of these criteria.

Optometrist Arto Hartikainen was able to use the device he invented and developed in his own work. The previously used finger perimeter, which was highly inaccurate and difficult to repeat, was replaced with the highly accurate and reliable ARTO-perimeter test. Already during the product's testing period, Hartikainen was able to successfully use the ARTO-perimeter in finding a serious defect in the visual field of a person looking to renew their driving licence. This defect could not be detected with finger perimeter and caused no subjective sensations to the person.

The scientific research conducted for the ARTO-perimeter took most time during the development process. Based on the research, the ARTO-perimeter was found to do well at detecting cases where there was binocular impairment in the central visual field. The ARTO-perimeter was also found to be wellsuited for the eyesight examinations carried out for driving licences.

The product is an official medicinal device. It has obtained the CE marking and been registered with the National Supervisory Authority for Welfare and Health Valvira, Finland. The ARTO-perimeter provides the simplest way to reliably test for defects in the central visual field in line with the vision requirements for a driving licence.

Ordering the ARTO-perimeter

The ARTO-perimeter is sold to health care companies (optician stores, private health centres etc.) and public communities (e.g. health centres). The one-off licensing fee is €150 (VAT 0%) per establishment. The client is obligated to purchase a separate licence for each of its establishments. In the context of licence holders, an establishment refers to a unit of the licence holder operating in one physical location. Licence holders are permitted to copy the ARTO-perimeter to all necessary workstations located within a single establishment without restrictions. The licensing terms are attached in full to the order agreement.

Submit an order as follows:

Download the order agreement HERE.

Fill out the order agreement and send it by e-mail to orders@optivisio.fi.

Optivisio will send the invoice to the client. Once Optivisio has received the payment on its account, the company will send the ARTO-perimeter file to the client as agreed in the order agreement.