History Taking & Visual Acuity

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History Taking &
Visual Acuity
Yuli Susanti
History Taking
1. Greeting (intonation, condition)
2. Chief complain
3. Information about present
illness
4. Past ocular history
5. Medical history
6. Social & Family history
Present illness
- Time and manner of onset
- Severity
- Laterality
- Clarification
- Documentation
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
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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
- 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 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
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
- 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 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 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 ......
1/∞
Pinhole Visual
Acuity Testing
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
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