1 SPERIAN TRAINING PRESENTATION Vision Screener PROFESSIONAL Slide Information

2 SPERIAN TRAINING PRESENTATION Basic Testing Information: Each model contains 8 test slides. Tests are administered at Far, Near and Intermediate distances. For ease in administration, follow test sequence under each category. If you wish to skip a test, continue with the next test in the sequence. Titmus Vision Screener PROFESSIONAL Slide 1 SA-APS-1 Allen Picture Test Slide 2 SAS-2 Acuity Right & Left Eye Slide 3 SPS-3 Heterophorias Slide 4 SCD-1 Color Percetion Slide 5 SA-BRL-4 Visual Acuity Slide 6 SLP-1 Lateral Phoria Slide 7 SVP-1 Vertical Phoria Slide 8 SA-BRL-2A Visual Acuity Slide & Testing Function CLICK ON SLIDE IMAGE TO LEARN HOW TO DO THE TEST.

3 SPERIAN TRAINING PRESENTATION Allen Picture Test Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA This is the Allen Picture Test. It test visual acuity (sharpness of the eye) and binocularity (both eyes working together). Test is administered at FAR for both eyes (binocularity), Right and Left Eye (acuity). Can test as young as 3 ½ years. Review pictures of Jeep, Telephone, Birthday Cake and Horseman with children before testing for better communication. Binocularity: On top line, what objects do you see? Acuity: What objects do you see on line….? Age tested Slide – SA-APS-1 BACK TO MAIN Acuity Right Eye Acuity Left Eye Binocularity (20/100) Jeep, Telephone, Cake, and Horseman Binocularity: PASS - All Images Seen FAIL - Two Images Seen Acuity, Right or Left Eye: PASS - 20/30 & 20/40 FAIL - 20/50 Binocularity: Test both eyes together (do not occlude) Acuity, Right Eye: Occlude Left Eye Acuity, Left Eye: Occlude Right Eye

BACK TO MAIN Allen Picture Test Slide – SA-APS-1

5 SPERIAN TRAINING PRESENTATION Acuity, Both Eyes Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA Tests visual acuity (sharpness of the eye.) Right and Left Eye images are different. Administer test at FAR and using PLUS Lenses. Refer to page 4 for Plus Lens Test. Ask the child to read the Pilot Line, starting with the big “E” at the Left. The pilot line is an indication of the visual acuity of the child, confirm this by asking the child to read the corresponding visual acuity line. Describe the “E” as “table with legs”, if needed and have child indicate direction of “legs”. Which direction is the “E” (are the table legs) pointing? Top, Bottom, Left or Right? When using Plus Lens, ask child to read 20/20 Line. For Blue, Red, Yellow & Green Lines, PASS – Ability to identify 4 out of 6 “E”’s on each line. With Plus Lens, FAIL if child can read 20/20 Line. Age tested Slide – SAS-2 BACK TO MAIN Left Eye Right Eye

BACK TO MAIN Acuity, Both Eyes Slide – SAS-2

7 SPERIAN TRAINING PRESENTATION Muscle Balance Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA This is a Muscle Balance Test to test Vertical and lateral Phoria in children. For children that fail this test, it helps identify if there is a possibility of amblyopia (lazy eye) or strabismus (squint eyes). Test is administered first at far and then at near. Occlude Left Eye and tell the child that you will throw a red ball and it should land in a “sandbox”. Then open the Left Eye and ask the question. Encourage a quick response because the “ball” will tend to “move” after a few seconds. If necessary, repeat the test. Is the red ball in Box A, Box B or the ground? NEAR: Ball in Box A or Box B is Pass, anywhere else is FAIL. Age tested Slide – SPS-3 BACK TO MAIN Box A, Box B or the ground. FAR: Ball in Box A is PASS, anywhere else is FAIL

BACK TO MAIN Muscle Balance Slide – SPS-3

9 SPERIAN TRAINING PRESENTATION Color Perception Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA Test red/green color perception. Test uses accurately reproduced Ishihara Pseudo-Isochromatic plates does not classify type or degree of severity. Individuals with 20/50 or less in both eyes may FAIL this test due to low acuity rather than deficiency. NOTE: To avoid memorization of numbers in circles, ask subject to respond randomly. (example, circle E, B, D, etc.) What numbers do you see in circles A, B, C, etc.? A total of 8 numerals should be seen: – “nothing” or “no number” in circle F is a correct response. Age tested Slide – SCD AB C DEF Normal:Correct reading of ALL 8 numerlas Mild Deficiency: Correct reading of at least 5 numerlas FAIL:Inability to read at least 5 numerlas BACK TO MAIN

Color Perception Slide – SCD-1

11 SPERIAN TRAINING PRESENTATION Acuity, Both, Right & Left Eye Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA This test checks for visual acuity of Both Eyes, Right Eye and Left Eye using the same slide. Start with the line the subject can see most clearly. Acuity levels may be different for each eye. You may use a different BRL test (like SA-BRL-2A) for NEAR to avoid memorization. Some individuals may have irregularities due to binocular vision problems: Right/Left column appears blurry, suppression of Right or Left Eye symbols, disappearance of symbols in left or right column, failure to fuse Right and Left Eye columns into three columns. Do you see three columns of letters? Read line from left to right. Direction for each line: Both Eyes Test:Read the letters in the middle column Right Eye Test:Read the letters in the right column Left Eye Test:Read the letters in the left column For each column of letters: Lines 1 & 2 – All letters must be read correctly Lines 3 to 7 – Allow to miss any one letter in a column Age tested Slide – SA-BRL-4 BACK TO MAIN

Acuity, Both, Right & Left Eye Slide – SA-BRL-4

13 SPERIAN TRAINING PRESENTATION Lateral Phoria Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA This is a Muscle Balance Test to define a value for the balance of the eyes in the horizontal direction. Occasionally, the subject may be confused. When this happens, momentarily occlude the Left Eye, which sees the red line. Ask the subject to respond immediately when the red line reappears. (Where do you first see the red line?) Remove occlusion. This is a binocular test. It should not be given to an individual with vision in only one eye. Do you see an arrow? The arrow points to which musical note? Age tested Slide – SLP-1 Based on job standard selected Laterall Phoria Key Notes on slide Prism Values Prism Diopters LEFT Hyperphoria ORTHO Prism Diopters RIGHT Hyperphoria BACK TO MAIN

Lateral Phoria Slide – SLP-1

15 SPERIAN TRAINING PRESENTATION Vertical Phoria Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA This is a muscle Balance Test to define a value for the balance of the eyes in Vertical direction. Occasionally, the subject may be confused. When this happens, momentarily occlude the Left Eye, which sees the red line. Ask the subject to respond immediately when the red line reappears. (Where do you first see the red line?) Remove occlusion. This is a binocular test. It should not be given to an individual with vision in only one eye. Do you see a red broken line: Through the round part of which musical note does the line pass Age tested Slide – SVP-1 Based on job standard selected ½1½0½1 Vertical Phoria key Notes on slide Prism Values Prism Diopters LEFT Hyperphoria ORTHO Prism Diopters RIGHT Hyperphoria BACK TO MAIN

Vertical Phoria Slide – SVP-1

17 SPERIAN TRAINING PRESENTATION Acuity, Both, Right & Left Eye Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA This test checks for visual acuity of Both Eyes, Right Eye and Left Eye using the same slide. For each column of letters: Lines 1:All letters must be read correctly Lines 2-6:Allowed to miss any one letter in a column Age tested Slide – SA-BRL-2A BACK TO MAIN Do you see three columns of letters? Read line from left to right. Direction for each line: Both Eyes Test:Read the letters in the middle column Right Eye Test:Read the letters in the right column Left Eye Test:Read the letters in the left column Start with the line the subject can see most clearly. Acuity levels may be different for each eye. You may use a different BRL test (like SA-BRL-4) for NEAR to avoid memorization. Some individuals may have irregularities due to binocular vision problems: Right/Left column appears blurry, suppression of Right or Left Eye symbols, disappearance of symbols in left or right column, failure to fuse Right and Left Eye columns into three columns.

BACK TO MAIN Acuity, Both, Right & Left Eye Slide – SA-BRL-2A

19 SPERIAN TRAINING PRESENTATION Binocular Vision Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA Test vision with Both Eyes working together The 2 white cubes should fuse together for a subject with good binocular vision. The functioning eye can be determined by asking the subject to identify the colors. How many cubes do you see? What are the colors of the cubes? Age tested Slide – SF-1 Three:PASS Four, then Three:PASS Four:FAIL, NO FUSION Two:FAIL VISION IN ONLY ONE EYE Three, Red / White / Blue BACK TO MAIN

Binocular Vision Slide – SF-1

21 SPERIAN TRAINING PRESENTATION Color Perception Testing distance TESTING FUNCTION TIPS PATIENT QUESTION PATIENT ANSWER PASS/FAIL CRITERIA Test color perception. Test uses photographically reproduced TITMUS Pseudo-Isochromatic blocks. Block No. 1 is introductory. For children, it is assumed that they are familiar tihe the “E” and know how to respond, Individuals with low visual acuity (20/70 or less) in both eyes may FAIL this test, due to low acuity rather than faulty color perception. This screening test checks for a problem in recognizing colors but does not classify type or degree of severity. In the boxes, which direction is the “E” (table legs) pointing? Top, Bottom, Left or Right? With preschool/primary grade children follow sequence as – Blocks 1,4,5,6,7,8 and then Blocks 2,3 since these are the most difficult. Age tested Slide – SPCD - 1 BACK TO MAIN Unconditional PASS:Correct reading of all blocks Conditional PASS:Correct reading of at least 5 blocks. FAIL:Inability to read at least 5 blocks Children who have a Conditional PASS in the second or lower grades may PASS when tested again in the higher grades

BACK TO MAIN Color Perception Slide – SPCD - 1

23 SPERIAN TRAINING PRESENTATION FAR – Testing Distance 20 ft BACK TO MAIN

24 SPERIAN TRAINING PRESENTATION NEAR – Testing Distance 14” BACK TO MAIN

25 SPERIAN TRAINING PRESENTATION INTERMEDIATE – Testing Distance 19” – 40” BACK TO MAIN

26 SPERIAN TRAINING PRESENTATION Peripheral Vision Lights BACK TO MAIN

27 SPERIAN TRAINING PRESENTATION Slide Position BACK TO MAIN TITMUS V4 TITMUS V2