Now let's review a pinhole acuity. When would you use this? This is typically done when the patient is unable to obtain a best-corrected visual acuity of 20/40 or better. Now let's walk through the procedure, and any time you are using a pinhole for acuity testing remember to keep the pinholes over the eye that's being tested. So let's begin. Have the patient remove correction. Have the patient keep both eyes open and cover their right eye with the occluder that has the pinholes and their left eye with a solid occluder. Your office may have binocular occluder to utilize in clinic. In that case, ensure that the side with the pinholes is over the eye that is being tested. Have the patient read the smallest line that they can see comfortably and document with the patient reports seeing. Have the patient keep both eyes open. Swap the occluders to the opposite eye. So now we have the occluder with the pinholes over their left eye. Have the patient read the smallest line that they can see comfortably and document what the patient reports seeing.
Please note pinhole acuities can only be done monocularly.