Yuli Susanti

1
History Taking Visual Acuity

• Yuli Susanti

2
History Taking

• Greeting (intonation, condition)
• Chief complain
• Information about present illness
• Past ocular history
• Medical history
• Social Family history

3
Present illness

• Time and manner of onset
• Severity
• Laterality
• - Clarification
• - Documentation

4
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

5
Others

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

6
Distance Visual Acuity Testing
7
Distance Visual Acuity Testing

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

8
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)

9
(No Transcript)
10
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

11
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

12
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)

13
LIGHT PERCEPTION AND PROJECTION

• - If the patient cant detect hand motion
• - Use a pen light to determine whether patient
  can detect the direction or perception of the
  light
• - Record the patients response as
• LP with projection/direction
• LP without projection/direction, or
• NLP (no light perception)

14
Visual acuity

• Interpretation
• 6/6 ........
• 2/60 ......
• 1/300 ......
• 1/8

15
Pinhole Visual Acuity Testing

16
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

17
ALHAMDULILLAH