Vision Therapy Intake Forms
Amsler Grid Test
An Amsler grid is a useful tool for monitoring your central visual field. It is an important way to detect early and sometimes subtle visual changes in a variety of macular diseases such as ARMD (age-related macular degeneration) central serous retinopathy, choroidal neovascularization for high myopia (over -6.00), and diabetic macular edema. It is also helpful in monitoring changes in vision once they have been detected.
Instructions for using the Amsler grid
Turn on the lights. Wear your reading glasses or look through the reading portion of your bifocals (if you normally read with spectacles)With Progressive or multifocal lenses you may notice some form of distortion. Distortions may occur as a result of the lens design and not your eyes. If you have a cause for concern please consult an eye care professional.
1. Hold the Amsler grid at normal reading distance (about 35cm).2. Cover one eye at a time with the palm of your hand.3. Stare at the center dot of the chart at all times.4. Do not let your eye drift from the center dot.5. Repeat for the other eye.
Determining a problem?
Are any of the lines crooked or bent?Are any of the boxes different in size or shape from the others?Do any of the lines seem wavy, missing, blurry, or discoloured?If the answer to any of these questions is “yes” (and this has not been noticed by you before), you should contact your optometrist as soon as possible for an examination. Remember, with Progressive or multifocal lenses you may notice some form of distortion. Distortions may occur as a result of the lens design and not your eyes. If you have a cause for concern please consult an eye care professional.
