Visual Acuity Examination

Distance Visual Acuity

Ask patient to
20 feet from chart
stand or sit

Ask patient to say Occlude the eye

aloud each letter or that not being
number tested

Note
corresponding
acuity
measurement,
separetely
 How to Read
• Record with and without
correction
• IF Patient can read all line
 read the line’s value
• IF miss half or fewer than
half the letter on
smallest readable line
Record how many letters
were missed ec:
6/12-2
Notation

D V SC OD 6/24
OS 6/18
OU 6/18

D V OD 6/6
CC OS 6/6 OU 6/6

6/18 +2
 Pinhole Visual acuity
If Acuity worse than 6/6 or 20/20
Position patient
Ask patient to use
and occlude eye
pinhole occluder
that not being
infront of eye
tested

Read the smallest

Instruct patient to
letter that are
look at distance
legible on previous
chart
vision test

Record the snellen

chart and use PH
 Notation

PH V
SC OD 6/24
OS 6/18
OU 6/18

PH V OD 6/6
CC OS 6/6 OU 6/6
 Near Visual Acuity
Wear habitual Instruct to hold
corrective test card at 40 cm

Ask patient to
Occlude one
each letter or
eye
word

Record it
 Notation

D V SC OD 6/24
OS 6/18
OU 6/18

D V OD 6/6
CC OS 6/6 OU 6/6
 Low Vision Test
If patient unable to
resolve the largest
optotype
SIT
10 Feet from the chart,
oclude one eye

Halve the test

distance (up to
2,5 feet)

Note
corresponding
Acuity
separately
 Low Vision Test
IF patient Unable to read largest optotypes from
2,5 feet  Count finger  Record longest
distance

Eg: CF at 2f
IF patient cannot count finger  hand
movement at 2 f Record longest distance

Eg: Hm at 2f
 Low Vision Test
Cannot Detect Hand motion  shine with
penlight  1 foot turn on-of Respons
(LP) or no Respons (NLP)

Identify direction  LP with Projection

Unable to Identify direction  LP without
Projection
 How to Read Low Vision Test
If can read 3 of 5
letters  take
the value +
0,02 per letter
not seen Bailey-
Lovie
Ex: Chart

0,6+ 0,02= 0,62

 Log Mar
LogMAR= -Log10 (desimal acuity)
desimal acuity = 10-logMAR
Ex:
Snellen : 6/60 logMAR?

- Log 101/10= -(-1)= 1,00

10-1 = 1/10= 6/60

Pediatric Visual Acuity Assesment

Friendly Toys
TECHNIQUES
Be aware with
child’s Comfortable
Respons
Pediatric Visual Acuity Test
Pre Verbal
Infant ( <1 yo)
Toddler ( 1-3 Verbal
yo)
Tumbling E
Preliterate HOTV
Fixation test Optokinetic (3-6 yo)
(CSM Metode
Nystagmus Lea-
and F&F) Symbols
 2month
Landolt-C
Forced-choice Allen chart
preferential looking
( FPL) teller acuity,
Decoration card , Keeler cards
Cardif cards,
cake
Literate
Pattren visual Snellen
(>6 yo)
evoked potentials chart &
(PVEP) Number
 INFANT
• fixation object
F& F methode

Select an object
Seat on the adult’s Hold object 1-2
that stimulate sight
lap feet
only

Move horizontally,
Observe infant’s watch infant’s eye
eyes  Fixation eye
movement
INFANT
Notation:
EX:
Fixation…Not Follow
 INFANT
CSM Methode Both eye
uncovered, Covered one eye for
observation for a about 3 second
manifest deviation

Fixation behaviour
Repeat for another
of uncovered eye 
eye
discovered

Note
 INFANT
Notation :
C=Central  Assesed by corneal light reflex when
the other eye covered (MONOCULAR)
S=Steady  a target moved slightly with the other
eye covered  if the uncovered eye takes up
central fixation steadily  steady (MONOCULAR)
M= Maintained  fixation ablility of child to
maintain fixation with the same eye when the
other is Uncovered at least through next blink
(BINOCULAR) Right eye : UC,S, UM…Left eye: C,S,M
 INFANT
Pincher grasp

=6/24
 Optokinetic Nystagmus

OKN Drump

8 to 10 rpm

See infant’s eye

movement

If it respons ,
implies finger
counting 3-5 feet
 FPL
Using Teller acuity Card

Presented to infant

Naturally infant prefer to look at

pattren if they can
be seen

Examiner looks through central

pinhole  determine baby’s
Gaze
Teller
 FPL

Keller Cardif
Cardif Card
 FVEP
Measure summed
occipital cortical responses
to a pattren stimulus

Reflect activity from

central retina

See amplitudo and latency

of spike

EEG Recording
 verbal
Preliterate (3-6 yo)
Tumbling E
 Lea’s symbols

Distance

Near
Landolt-C & Allen
 HOTV

Near Vision Distance Vision

 verbal
• Literate (>6)

Snellen Chart Letter

 Contrast Sensitivity
• A measure of the ability of the visual system
to distinguish an object against its background

• Target :
– Sufficiently large to be seen
– High enough contrast with its background
 Contrast Sensitivity
• ↑ contrast  easier to decipher
• Contrast = I max – I min
I max + I min

Imin = brigthness of an object

Imax = brightness of its background

• Contrast 100%  Snellen chart

– black ink (Imin= 0) on white paper (Imax=100)
 Hiding Heidi

1.25%, 2.5%, 5%, 10%, 25% and 100%.

Large Mixed Contrast Card
The Rabin
 Stero Acuity Test

If +

Record the
stereospis
as second of arc
AAO