MACP 323 - CH43 P43-2

NEAR VISION

MATERIALS: Eye occluder or card to block vision in one eye; alcohol; gauze squares; appropriate vision charts to test for distance vision, near vision, and color blindness; patient chart/progress note

Performing Vision Screening Tests Procedure 43-2

PROCEDURE GOAL: To screen a patient’s ability to see distant or close objects, to determine contrast sensitivity, or to detect color blindness

OSHA GUIDELINE: Wash your hands and have a biohazard waste bin nearby for use

DISTANCEVISION

COLOR VISION

DISTANCE VISION

Performing Vision Screening Tests Procedure 43-2

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15

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19

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21

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NEAR VISION

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27

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33

COLOR VISION

Step 18

Clean the occluder with a gauze square dampened with alcohol.

STEP 22

Ask the patient to keep both eyes open and to read or identify the letters, symbols, or paragraphs.

Step 13

Have the patient cover the right eye and read the lines on the chart.

Step 32

Properly dispose of the gauze square and wash your hands.

Step 3

Make a mark on the floor 20 feet away from the chart.

Step 4

Drop the object directly into an approved puncture-proof container for sharps. Engage safety device, if indicated.

Step 19

Properly dispose of the gauze square and wash your hands.

STEP 21

Have the patient hold one of the following at normal reading distance (approximately 1 4–1 6 inches): Jaeger, Richmond pocket, or similar chart or card.

Step 10

Show the patient how to cover the left eye with the occluder or card. Again, instruct the patient to keep both eyes open and not to squint or lean forward during the test.

Step 29

Proceed through all the charts or pages, usually totaling 24.

Step 2

Mount one of the following eye charts at eye level: Snellen letter or similar chart (for patients who can read); Snellen tumbling E, Landolt C, pictorial, or similar chart (for patients who cannot read). If using the Snellen letter chart, verify that the patient knows the letters of the alphabet. With children or nonreading adults, use demonstration cards to verify that they can identify the pictures or direction of the letters.

Step 26

Wash your hands, identify the patient, introduce yourself, and explain the procedure.

Step 30

Record the number correctly identified and failed with a slash between them (e.g., 23 passed/1 failed).

Step 12

Record the results of the right eye (e.g., Right Eye 20/30).

Step 17

Ask the patient to keep both eyes open and to identify the color of the two colored bars on the Snellen chart, and record the results in the patient’s chart.

Step 1

Wash your hands, clean the occluder with a gauze square dampened in alcohol, identify the patient, introduce yourself, and explain the procedure.

STEP 20

Wash your hands, identify the patient, introduce yourself, and explain the procedure.

Step 15

If the patient wears corrective lenses, record the results using cc (if your office uses this abbreviation for “with correction”) in front of the abbreviation (e.g., cc Both Eyes 20/20).

Step 27

Hold one of the following color charts or books at the patient’s normal reading distance (approximately 1 4–1 6 inches): Ishihara, Richmond pseudoisochromatic, or similar color-testing system.

Step 28

Ask the patient to tell you the number or symbol within the colored dots on each chart or page.

STEP 24

If the card is laminated, clean it with a gauze square dampened with alcohol.

Step 5

Instruct the patient to keep both eyes open and not to squint or lean forward during the test.

Step 14

Record the results of the left eye (e.g., Left Eye 20/20).

Step 11

Have the patient read the lines on the chart.

Step 6

Test both eyes first, then the right eye, and then the left eye. (Different offices may test in a different order. Follow your office policy.)

Step 8

Note the smallest line the patient can read or identify with no more than two errors. (Some offices allow only one error per line. Follow office policy when performing this test.)

Step 16

Note and record any observations of squinting, head tilting, excessive blinking, or tearing.

Step 4

Have the patient stand with their heels at the 20-foot mark or sit with the back of the chair at the mark.

Step 33

Document the results after you have completed the procedure.

STEP 25

Properly dispose of the gauze square and wash your hands.

STEP 23

Record the smallest line read without error.

Step 31

If the charts are laminated, clean them with a gauze square dampened with alcohol.

Step 9

Record the results as a fraction (e.g., Both Eyes 20/40 -1 if the patient misses one letter on a line or Both Eyes 20/40 -2 if the patient misses two letters on a line).

step 7

Have the patient read the lines on the chart (or identify the picture/direction), beginning with the 20-foot line. If the patient cannot read this line, begin with the smallest line the patient can read. (Some offices use a pointer to select one symbol at a time in random order to prevent patients from memorizing the order.)