ASSESSMENT OF VISUAL

ACUITY
DEFINITON OF VISUAL ACUITY

• It is the measure of spatial resolution of eye (or) estimation of its

ability to discriminate between two closely placed points.
PHYSIOLOGICAL BASIS OF VISION
• Angle subtended at the nodal point of eye by physical dimensions AB
of the object.
Visual acuity is a highly complex function that consists of

Minimum visible: Detection of presence or absence of stimuli

Minimum separable: Identify the spatial characteristics of the target
Minimum resolvable : Ability to distinguish between more than one
identifying feature in visible target
MINIMUM ANGLE OF RESOLUTION( MAR)
• Two points can be recognized as separate when they subtend an angle
of 1 min of arc at nodal point of eye.
• The normal angular threshold of discrimination for resolution measures
approximately 30-60 sec of arc called MAR
SNELLENS ACUITY CHART
• Designed by Dr.HERMAN SNELLEN IN
1862
• Symbols and letters are called optotypes
• Black capital letters against white
background
• Number of letters varies in different lines
• Non-uniform decrease in size of letters from
top to bottom
• Fixed spacing between lines
• Evenly illuminated
PROCEDURE OF TESTING
• Distance -6m or 20 feet
• Illumination
Illuminated chart- dimly lit room
Non- illuminated- chart in sun, patient in
shade
• One eye at a time
• Start reading from top till he can see the
finest line
• Repeat with pinhole and spectacle correction
SNELLEN’S FRACTION

6/6
Distance of the test
--------------------------------------------------------
Distance at which a person with normal vision can see the optotype
 What if person can’t read the top letter?
• Move 1 meter closer to the chart (5/60)
• Keep moving (4/60-1/60)
• Count fingers close to face
• Appreciates hand movement (HM +)
• Perceive light (PL+)
• If PL + ,Projection of rays in different
quadrants
VA ASSESSMENT IN CHILDREN:

Normal visual acuity in various age groups are

• At birth - 6/120
• 4 months-6/60
• 6 months-6/36
• 1 year-6/18
• 2 years- 6/6
INFANTS
• MENACE REFLEX-reflex blinking in response to visual threat
Develops by 5 months
• OPTO-KINETIC NYSTAGMUS –
A succession of black and white stripes are passed through the
patient's visual field.
• CATFORD –DRUM TEST:
It is an objective method to evaluate the objective visual acuity by
inducing optokinetic nystagmus.

• PREFERENTIAL LOOKING TEST:

Infant's attention is more attracted by a patterned stimulus as
compared to a homogenous surface .
• Teller's acuity cards
The cards are shown at a distance of 38 cm, an observer watches an infant's
eye and head movements in response to repeated presentation of these cards.

• Lea's gratings
Preferential looking test used for visual acuity assessment of infants and
children with disability.
• VEP
The measure of the cortical activity generated in response to the patterned
stimulus
1-2 YEARS:

• Worth’s Ivory Ball Test

• Boeck Candy Test

2-3 YEARS
• Cardiff acuity test
• Miniature toy test
• Coin test
• Lea symbols
3-5 YEARS
• Allen’s picture test
• Sheridan letter test
• Lea symbols
• Tumbling E test
• Sjogren’s hand test
• Landolt broken ring test (VA assessment in illiterates)
THANK YOU