DMV Policy

North Carolina Board of Examiners in Optometry

Policy Statement on Window Tinting and other North Carolina Department of Motor Vehicles (DMV) Issues:

This Policy covers the following three issues:


1. Window Tinting and Window Tinting Waivers. 

Executive Summary On Window Tinting and Waivers:  

Detailed Statement on Window Tinting and Waivers

“Individuals with a photosensitivity to light (emphasis added) who need darker window tints can apply for a medical exception permit with the N.C. Division of Motor Vehicles' Medical Review Program.” 







2.  DMV Form 77 Question 18 – Statement on patient’s medical condition(s) and potential effect on safe driving ability.

Here is Question 18 from DMV Form 77 (DL-77 Rev. 2/2019 - North Carolina Department of Motor Vehicles - Vision Specialist) with a considered statement regarding the extent of the optometrist’s evaluation of the patient. 

18.  Has the driver been involved in a recent motor vehicle accident because of their medical conditions? Yes ___ No ___ 

Give your overall assessment of this patient's medical condition and any potential effect on safe driving. 

Please comment on all medical conditions and any over-the-counter or prescription medications that might exacerbate the risk of driving. ________________________________________________________________

My comments are related to my examination of the patient’s ocular and visual status.  The patient’s overall medical status would best be addressed by the patient’s PCP. 

A typical question from a licensee regarding Form 77, Question 18:

How am I supposed to comment on all of the patient’s medical conditions when I am only examining the patient’s eyes and being asked to complete the DMV form DL-77?

In the first section of question Question 18, where it asks for a history of a motor vehicle accident, it asks for a yes or no answer.  If the answer to that question is unknown, the Board would suggest answering the question by writing “unknown” as the response. 

As to the second set of directions [overall assessment], absent the OD’s knowledge of any pertinent ocular or visual information, the Board believes an appropriate response might be what is stated above in red ink.

A similar response was found on the internet:

As an eye care specialist, my care and evaluation of this patient is related to their ocular health and vision, and it would be inappropriate to comment on this patient’s overall medical status under the care of their PCP or otherwise. My comments are related to my examination of the patient’s ocular and visual status. 

AMA Code of Ethics Opinion 8.2 also may provide guidance:

Impaired Drivers & Their Physicians:

“Not all physicians are in a position to evaluate the extent or effect of a medical condition on a patient’s ability to drive, particularly physicians who treat patients only on a short-term basis. Nor do all physicians necessarily have appropriate training to identify and evaluate physical or mental conditions in relation to the ability to drive. In such situations, it may be advisable to refer a potentially at-risk patient for assessment.”


3.  Requirement to report a patient with a visual disability that you believe may affect the patient's ability to operate a motor vehicle safely.

Question from an optometrist sent to the Board:

Are optometrists obligated in North Carolina to report to the DMV regarding who should have driving privileges removed or recommend glasses for driving? Also, are optometrists held liable if an accident were to occur?


North Carolina General Statute section 20-9.1 contains guidance on this issue:

 ”Notwithstanding…any other law relating to confidentiality of communications between physicians…or other medical providers and their patients…a physician…or other medical provider duly licensed in the State of North Carolina may disclose after consultation with the patient to the Commissioner information about a patient who has a physical or mental disability or disease that the physician…or medical provider believes may affect the patient’s ability to operate a motor vehicle safely.  This information shall be limited to the patient’s name, address, date of birth, and diagnosis.”  G.S. 20-9.1(a) (underlining added). 

“A physician…or other medical provider disclosing or not disclosing information pursuant to this section, or conducting an evaluation and making a recommendation to the Division regarding a person’s ability to operate a motor vehicle safely,  is immune from any civil or criminal liability that might otherwise be incurred or imposed based on the disclosure or lack of disclosure provided that the physician…or other medical provider was acting in good faith and without malice. In any proceeding involving liability, good faith and lack of malice are presumed.” G.S. 20-9.1(c).

If you are asked by the North Carolina DMV or a patient to complete DMV Form DL-77, you obviously should state accurately your clinical findings for that patient and your impression of the patient's ability to drive based on such clinical findings.

However, If you examine a patient who is not requesting that Form DL- 77 be completed and you do observe findings that would limit or disqualify the patient from meeting the NC DMV visual standards for driving, you are under no legal obligation to report your findings to the DMV.  See the “may” underlined in G.S. 20-9.1(a) above: North Carolina is not a mandatory reporting state.  North Carolina has no statutory provision requiring physicians to report to a central state agency patients diagnosed with conditions that could limit or affect the patient’s driving ability. However, while you are not legally obligated to report a disqualifying condition, you have the option to do so and you are protected from civil liability if you choose to do so (assuming you otherwise comply with G.S. 20-9.1).  G.S. 20-9.1(c). 

You should use your professional judgment in deciding whether to report a situation or condition you believe may affect the patient’s ability to operate a motor vehicle safely. For example, a patient presents with a history of a recent stroke, and your finding shows a right or left homonymous hemianopsia. That patient’s driver’s license does not expire for three years, and the patient intends to continue driving.  Arguably, you have moral and ethical considerations in deciding whether to report:  a failure to report the patient’s condition could jeopardize not only your patient but also other drivers and pedestrians. Regardless of your decision on whether to report such a condition, you are obligated to have a frank discussion with the patient and document the medical record that you informed the patient of your findings and how that would limit or disqualify them from driving by NC DMV standards. 

If you decide to report your findings to the DMV, you would do so on the North Carolina DMV Request for Driver Re-Examination Form

If reporting a patient, I would do so following a review of G.S. 20-9.1 and the AMA’s Code of Ethics Impaired Drivers & Their Physicians, which provides sound advice on how to fulfill your professional responsibility and at the same time, respect the patient’s privacy and confidentiality.