2.

VISUAL ACUITY TEST

i. Theory:
Visual acuity test is an exam that determines the details of a word or symbol that can be seen
from a specific distance away. It is a measurement of best corrected distance vision. Patients with
short sighted and normally wear glasses or contact lenses should have their visual acuity tested
wearing their glasses. Testing without corrected distance vision provides no relevant information.
Visual acuity is done as a diagnostic tool and it provides baseline data of the measurement of
progression of the disease. It is also done to evaluate the treatment given. For a normal vision to
function, it needs:
1. Both eyes in alignment(extraocular muscles functioning)
2. Clear cornea, lens and ocular media
3. Intact retina, optic nerve, visual pathway.
If one of these components affected, the vision will be impaired. And patients should be able to
recognise the images used on the charts (letters, shapes, numbers).
Most of the time, Snellen Chart is used for testing distance vision and E chart for children
and patients who cannot read. The chart is designed to be read at 6 metres or 3 metres. The chart is
standardised for size and contrast.

ii. Objectives:
1. To learn and familiarize with the techniques of the visual acuity test.
2. To know the clinical applications of using Snellen chart in the visual acuity test.


iii. Procedures:
1. Each eye needs to be tested separately and use an occluder to cover the eye that is not being
tested. If glasses are worn, the occlude goes over the top of the glasses. Avoid pressure on the
eye and patients should not peek through their fingers.
2. Place patient 6 metres (20 feet) from the chart. Cover the left eye with an occluder.
3. Use adequate illumination, ask patient to read from the top letter. Encourage patient to relax
and blink regularly.
4. Keep going until he or she cannot read the line clearly and start to make multiple errors. The
previous line is the line that should be documented.
5. Repeat step 1 until 4 for right eye.
6. If the subject wore glasses, the test was performed initially without eyeglasses or
contact lens. Then, the test was performed with the eyeglasses.



iv. Results:
Subject
Unaided Aided
Left Right Left Right
A 20/70 20/100 20/20 20/25
B 20/50 20/50 20/15 20/15



v. Comments:
Visual acuity is expressed as a fraction.
The top number refers to the distance of the subject from the chart; 20 feet.
The bottom number indicates the distance at which a person with normal eyesight
could read the same line the subject correctly read.
Visual acuity of unaided Subject A for the right eye is 20/100, that is less than normal.
20/100 means that you must be as close as 20 feet to see what a person with normal vision
can see at 100 feet. The result for the subjects unaided left eye is 20/70, which is slightly
worse. When aided, the results for the subjects right and left eye is 20/25 and 20/20
respectively. Probably, the subjects short-sightedness had worsen since the time the subject
made his/her glasses.
Visual acuity of Subject B (20/15) is better than average according to the Snellen test.
However, a farsighted (hyperopic) individual who achieves this score may not be able to
focus well on closer objects.