Testing Vision Scenario

  1. A 65 year old patient attends complaining of poor vision in his left eye. He noted it last week. He wears glasses, and last saw an optometrist 2 years ago.
  • What further aspects of history are important?
  • Should you check his vision wearing his glasses?
  • If his pinhole vision is worse, what could that suggest?

Another common reasons a GP may wish to record a patients visual acuity (VA) is for HGV medical, where you have to complete form D4.

There is an excellent pamphlet to accompany this, which you should read if you are undertaking your first fitness to drive medical. (The vision standards are on pages 7-8.)

One thought on “Testing Vision Scenario

  1. stapsell Post author
    • Is the visual loss in all parts of his vision, or to one side?

    Loss of top or bottom part of vision is very suggestive of an eye cause of his symptoms. Most common would be glaucoma or a branch retinal vein occlusion. Loss of vision to the left side of his vision may actually be binocular (homonymous) loss due to a stroke.

    • Always check distance vision wearing distance glasses, then use pinhole in addition
    • Pinhole vision tends to improve refractive error and nuclear cataract, but will worsen vision due to macular problems or posterior subcapsular cataract
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