Checking Recording Vision TeleICare What is Visual Acuity

Checking & Recording Vision Tele-I-Care

What is Visual Acuity? • Visual acuity (VA) is commonly referred to as the sharpness of vision, measured by the ability to discern letters or numbers at a given distance from an eye chart according to a fixed standard. • 20/20 vision is considered "normal" vision, meaning what you can read at 20 feet is what a person with normal vision would read at 20 feet. • If a patient reads the 20/200 line that means what they can read at a maximum of 20 feet away from the chart is what a person with normal vision could still read at 200 feet. This indicates that the patient has very poor vision. 2

Steps to Checking Vision Make sure patient is wearing glasses or contacts for distance if they have them! Reminder: Record whether or not they are wearing corrective lens on Quick Screening: 1. Have patient stand at appropriate distance from eye chart (either 10 or 20 ft. depending on the chart) 3

Steps to Checking Vision 2. Begin screening by having the patient read the chart only with their right eye. • Give patient the occluder and have them cover up their left eye. 4

Steps to Checking Vision 3. With the right eye, have the patient read the smallest line they can see on the eye chart. • If the patient reads all letters on the line correctly, have them read the line below. * • If the patient reads half the letters or more on the line correctly, have them read the line below. * • If the patient reads less than half the letters on the line correctly, have them read the line above. *If the patient cannot read half the line below, record the value [20/__] for the line above and say + the number of letters they read correctly on the line below. 5

Check Vision Using a Pinhole Occluder 4. If the patient cannot see the 20/40 line, use the pinhole test to see if it improves the patient’s vision. • This technique helps to focus the light and removes the effects of refractive errors such as myopia (or nearsightedness) and acts like glasses. • Using the occluder put the pinhole flap over the opening and have the patient wiggle the occluder back and forth until they find a hole that makes it look clearer for them. • Then have the patient read the lowest line they are able to read. • Record the vision as PH: 20/___ just as you did for vision measured without the pinhole occluder. Remember to record + or – letters if the patient reads more than or less than the full line. 6

Steps to Checking Vision 5. Repeat steps for the left eye. 6. Repeat steps for both eyes open without the occluder. You do not need to do the pinhole test for both eyes. 7

Record Vision • If the patient reads all the letters on the 20/30 line correctly and cannot read the line below, you would record their vision as 20/30 • If the patient is reading the 20/30 line and can read more than half the letters on the line correctly, but misses two letters you would record that vision as 8

Record Vision • If the patient is reading the 20/30 line and reads all the letters correctly and then reads 2 letters of the next smaller line, their correct vision would be 20/30 +2 • You can use that notation with any line of vision no matter what the number of letters are, just remember to put the minus (-) or plus (+) sign next to the letters you record for each patient. 9

Patients with Poor Vision • If the patient cannot read the largest letter on the chart, you can note that they cannot see the chart in the Tele-I-Care portal. 10

Detailed Vision Screening 11

Patients with Poor Vision: Light Perception Technique • You can still record their vision by doing the following: Ask the patientdo you see the light in the room? • If they don’t see the light, the vision in that eye is documented as No Light Perception or NLP. • If the patient sees the light, hold your hand in front of their eye while making sure they are covering their other eye. Move your hand from side to side and ask the patient if they can see your hand moving. If they can’t see your hand, but see light, then their vision in the eye being tested is Light Perception or LP. 12

Patients with Poor Vision: Counting Fingers Technique • If they can see your hand waving, then they have at least hand motion vision, and you should hold up your fingers and ask them how many fingers you are holding up. • If they see your fingers correctly, record CF (counting fingers). 13

Patients with Poor Vision: Hand Motion Technique • If they cannot see your fingers even when you hold them close to their face, but can see movement of your hand, then record their vision as hand motion for the eye you are testing. 14

Tele-I-CARE 15

Self Check Questions: 1) What does it mean if a patient reads the 20/200 line? a) Patient has good vision b) Patient has poor vision 2) (T/F) When checking vision, it is important that the patient wear their glasses or contacts to read the letters on the chart. 3) If the patient is reading the 20/30 line and reads all the letters correctly and then reads 1 letter of the next smaller line, their correct vision would be a) 20/30 +1 b) 20/30 c) 20/25 +1 d) 20/25 -6 4) What should you do if the patient reads less than half the letters on the line correctly? a) Record that line with – numbers of they missed b) Have them read the line above c) Have them read the line below d) Record that line with + numbers they read correctly 5) (T/F) If the patient cannot see the 20/40 line, use the pinhole test to see if it improves the patient’s vision. 6) If the patient reads all the letters on the 20/30 line correctly and cannot read the line below, you would record their vision as ____? Answer: 20/30 16