History Taking Visual Acuity Yuli Susanti History Taking

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History Taking & Visual Acuity Yuli Susanti

History Taking & Visual Acuity Yuli Susanti

History Taking 1. 2. 3. 4. 5. 6. Greeting (intonation, condition) Chief complain Information

History Taking 1. 2. 3. 4. 5. 6. Greeting (intonation, condition) Chief complain Information about present illness Past ocular history Medical history Social & Family history

Present illness - Time and manner of onset - Severity - Laterality - Clarification

Present illness - Time and manner of onset - Severity - Laterality - Clarification - Documentation

Past Ocular History Why, When, How, Where, by Whom - Use of eyeglasses or

Past Ocular History Why, When, How, Where, by Whom - Use of eyeglasses or contact lenses - Use of medication in the past - Ocular surgery - Ocular trauma - History of amblyopia or ocular patching in childhood

Others v v v Ocular medication General medical and surgical history Systemic medication Allergies

Others v v v Ocular medication General medical and surgical history Systemic medication Allergies (onset, cause) Social History Family History (Ocular, Non ocular disease)

Distance Visual Acuity Testing

Distance Visual Acuity Testing

Distance Visual Acuity Testing - Snellen chart/projector, alphabet, inverse E, picture - Distance :

Distance Visual Acuity Testing - Snellen chart/projector, alphabet, inverse E, picture - Distance : 20 feet / 6 m - Well-illuminated - Measure each eye one by one

Distance Visual Acuity Testing 1. Distance 6 m, well illuminated chart 2. Measure uncorrected

Distance Visual Acuity Testing 1. Distance 6 m, well illuminated chart 2. Measure uncorrected visual acuity 3. Exam the right eye, occlude the left eye 4. Make sure there is no conscious or inadvertent peeking 5. Ask the patient to read the largest optotypes (E), from left to the right, until the patient correctly identifies at least one half of the optotypes on a line 6. Record the measurement as VOD 6/…. . or 20/. . . and record how many letter were missed (Example : VOD 6/12 F -1) 7. Repeat the procedure for the other eye (VOS)

Distance Visual Acuity Testing If the patient is unable to read the Largest Snellen

Distance Visual Acuity Testing If the patient is unable to read the Largest Snellen letter, proceed Fingers counting (1 -6 m) If the patient cannot count fingers, proceed Hand Motion (1 m) If the patient cannot detect hand motion, proceed Light Perception (30 -40 cm) if there is LP proceed Light Projection / Light Direction

Finger Counting - If the patient is unable to read the Largest Snellen letter

Finger Counting - If the patient is unable to read the Largest Snellen letter - Start distance 1 m (from the patient) - Ask the patient to count the number of the fingers - Record the distance at which counting fingers is done accurately (until 6 m) example : VOD 1/60 or … distance/60 - Repeat the prosedure for the other eye

HAND MOTION - If the patient cannot count fingers - Ask the patient to

HAND MOTION - If the patient cannot count fingers - Ask the patient to mention the direction of your hand (Up and down or Right to left) - Record positive respone as hand motion Example (VOD : 1/300 or HM)

LIGHT PERCEPTION AND PROJECTION - If the patient can’t detect hand motion - Use

LIGHT PERCEPTION AND PROJECTION - If the patient can’t detect hand motion - Use a pen light to determine whether patient can detect the direction or perception of the light - Record the patient’s response as : LP with projection/direction LP without projection/direction, or NLP (no light perception)

Visual acuity Interpretation : 6/6. . . . 2/60. . . 1/300. . .

Visual acuity Interpretation : 6/6. . . . 2/60. . . 1/300. . . 1/∞

Pinhole Visual Acuity Testing

Pinhole Visual Acuity Testing

Pinhole Visual Acuity Testing To know that the acuity measurement as stuctural or refraction

Pinhole Visual Acuity Testing To know that the acuity measurement as stuctural or refraction disorder - If visual acuity is less 6/6 - Repeat the prosedure of distance visual acuity testing starting at the last line of the acuity measurement - Ask the patient to look at the distance chart through the pinhole - Record the acuity as : VOD 6/12 PH 6/6