July 26, 2013 | POSTED BY | Clinical Pearls
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With some patients, the process of taking VA’s can feel like an eternity. To shave some time off your exam and still be accurate, follow these easy steps to avoid those patients who like to read every single letter on the VA chart:

#1. Isolate a VERTICAL line of letters ranging from 20/50 to 20/20 (higher if necessary).

#2. Ask the patient to tell you the smallest letter they can see as he/she looks down the vertical line of letters.

#3. From that letter size in step #2, put a horizontal line of letters with that same size and ask the patient to read it.

This is a good starting point and you can easily flip from one line to another without having to put the entire chart up.

Also, remember that there is always a reason why a patient cannot see 20/20. Your assessment for the patient must state why the patient cannot see 20/20 and what your plan is for that assessment. Whether it’s cataracts, pathology, amblyopia, refractive error, etc, there is always a reason that must be stated and recorded before the patient leaves the exam.


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