Other Factors

Let’s also think about other factors in the environment that we create for the patient outside of the physical environment. Sometimes we ask patients to read a line, let them struggle, and spend a copious amount of time along with creating a stressful environment. Try to begin with a line that the patient can read comfortably so the patients feels successful and less anxious. A patient who is more concerned about giving you the right answers may delay your workup time. Stay focused on our goal, to make the patient see better and their vision more comfortable. It is important that we are mindful of our time and schedule management.

Always observe the patient. Remember, no squinting. Squinting changes the shape of the cornea through applied pressure from the lids thus providing unreliable data for a patient's visual acuity. Squinting also changes the patients depth of field and focus, which may also affect the visual acuity, note if visual acuity is better with one eye or both eyes, recognizing patterns in reporting. Also, to note any inconsistencies. This could be important for AMD patients that may miss the center letter each time. So, as you observe these inconsistencies and consistencies or patterns, it can help in determining a diagnosis for a patient sometimes.