1. VISION SCREENING 101

2. Dr. Thanh (Kai) Nguyen
University of Florida 2005
Nova Southeastern College of Optometry 2009
You & Eyes 2011

3. You & Eyes www.youandeyes.com 407-658-6580

4. Importance of Wellness Eye Exam
An important part of preventive health care
Please note that a person can have “20/20” eyesight, with or without glasses, yet he/she may have an eye problem.
Many eye and vision problems have no obvious signs or symptoms such as glaucoma, tumor, cancer, retinal detachment, and optic nerve/retinal diseases
Early diagnosis and treatment of eye and vision problems
Preventing vision loss
Detection of many general health problems such as diabetes, high blood pressure, heart disease, infectious diseases, and vascular diseases.

5. Wellness Eye Exam
Complete internal and external health check of the eyes
Eye focusing, eye teaming, and eye movement abilities assessment
Ocular muscles, blood vessels and nervous systems evaluation
Risk assessment of eye diseases resulting from general health problems and family history of eye problems
Refractive error (nearsightedness, farsightedness, astigmatism, or presbyopia) evaluation
Dilated pupil posterior ocular segment evaluation

6. Vision Screening Intake Questionnaires Extra Ocular Muscle Test (EOM)
Near Point Convergence (NPC)
Accommodative Amplitude
Suppression Test – Depth Perception
Confrontation Field Test (CF)
Color Vision Test
Visual Acuity Test (VA)

7. Look for these common warning signs in children/teenagers
Blurred and/or double vision
One eye turning in or out
Squinting, eye rubbing, or excessive blinking
Red, sore, itchy eyes
Headaches, dizziness, or nausea after reading
Head tilting, closing or blocking one eye
Avoidance of near work

8. Look for these common warning signs in children/teenagers
Trouble seeing the board
Book held too close to the eyes
Confuses similar looking words
Poor reading comprehension
Tired and sleepy after reading
Dislike reading
Frequent loss of place during reading

9. Vision Screening Visual System
Visual Acuity Test
Color Test
Suppression Test
Confrontation Field Test
Eye Teaming System (Convergence/Divergence)
Near Point Convergence
Extra Ocular Test
Accommodative System (Focusing)
Accommodative Amplitude

10. Visual System “20/20” Eyesight With or Without Glasses Healthy Eyes
Refractive Errors
Myopia
Hyperopia
Astigmatism

11. Anatomy of the eye

12. Myopia

13. Hyperopia

14. Astigmatism

15. Visual Acuity (VA) Test
VA Distance 20/30 -1 OD @Near 20/20 OD
20/25 +2 OS /25 OS
VA(sc) @ Distane 20/200 OD @Near 20/30 OD
20/ OS /20 OS
CC = With Correction
SC = Without Correction
Stand at 20 Feet From Chart
No Squinting
Test One Eye At a Time
Sometimes Patients Still Need Rx Even if Patients See “20/20’ - Hyperopia

16. Visual Acuity Test
30 E L G P T 25 S P H B E 20 D T C B O

17. Color Test OD: 14/14 OS: 12/14 #3,8 Age Limit: All Ages
Test One Eye At a Time
Require Good Vision
EyeHandBook App
High Rx, Retinal Disorders, Optic Nerve Diseases, Cataract

18. Color Test Number of Plate Normal Person
Person with Red-Green Deficiencies
Person with Total Colour Blindness and Weakness 1 12 2 8 3 X 5 4 29 70 74 21 6 7 45 9 11 16
Traceable
Protan
Deutan
Strong
Mild 13 35
(3) 5
3 (5) 14 96
(9) 6
9 (6)
Can trace two lines
Purple
Purple (red)
Red
Red (purple)

19. Suppression Test
Require good vision - Need to wear glasses or contact lenses
Test both eyes together
Worth 4 Dot
Right Eye – Red Filter – See 2 Dots
Left Eye – Green Filter – See 3 Dots
High Rx, Amblyopia, Strabismus

20. Suppression Test

21. Confrontation Field (CF) Test
Gross Peripheral Vision Test Only
Preferred Without Glasses
FTFC OD, OS (Full to Finger Count)
Age Limit: All Ages
Test One Eye At a Time
80cm From The Patients
Optic Nerve Pathway, Ocular Diseases

22. Confrontation Field Test

23. Extra Ocular Muscle (EOM) Test
FROM OU (Full Range of Motion)
Age Limit: All ages
Test Both Eyes Together
Check For Full Extension, No Double Vision, No Pain
Perform Without Glasses
Ocular Muscle Problems, Cranial Nerve Disorders, Compression

24. Extra Ocular Muscles (EOM)

25. Extra Ocular Test
(SO4LR6)3

26. Near Point Convergence (NPC)
Convergence Disorders
Require Good Eyesight – Wear Best Correction
Require a Small Target
Test Both Eyes Together
Start at 40cm
Bring target close to patient’s nose until the patient reports blurry target, then double or you notice an eye turn outward, then pull target out until patient report single vision
Measure the distances from the target to the eyes (Blurry Distance/Double Vision Distance/Single Vision Distance)
Normal Value: 5-7cm (see double)/11cm (see single again)

27. Accommodative Test Donder’s Push Up Method Accommodative Disorders
Need Small Target
Test One Eye At a Time
Start at 40cm
Push Target Toward Eye Until Blurry
Measure Distance From Target to Eye (Blurry Target to Eye)
Require Good Eyesight – Wear Best Correction
1/Distance At Blur (For Example: 1/0.1m = 10D

29. The End!