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Low Vision Evaluation & Intevention Cheat Sheet by

low vision eval. and intervention


1. Use a magnifier
There are several to choose from including stand, hand-held and electronic
2. Increase the size of the print
You can use a bigger font or increase the size of the copier
3. Get closer to something
This is called relative magnif­ication


1. Hand-heald magnifier (with or without lighting attacheed)
Advant­ages: easy to carry on your person, simple to use, relatively inexpe­nsive
Disadv­ant­ages: small area of view, precise distance to maintain, difficult to perform two-handed activities
2. Stand magnifiers that are placed on a surface and don't need to be held by the client.
Advant­ages: easy to use for someone with arthritis or tremors, the focal distance is already held, and the lighting is very good
Disadv­ant­ages: bulky, can not write under most stand magnif­iers.
3. Electronic magnifiers cover a wide variety of magnifiers from CCTVs to portable magnifiers (e.g smartp­hon­e);best for those with poor vision and/or read continuous text
Advantage: the amount of enlarg­ement provided, easy to write under, fairly simple to use.
Disadv­ant­ages: Prince, size of the device, need to scan page when enlarged
4. Frame Mounted Magnifiers (These include half-eye specta­cles, TV glasses, sporting specta­cles, and loupes.)
Advant­ages: hands-free use, relatively lightw­eight, adjust­able, (TV glasses or sporting specta­cles)
Disadv­ant­ages: half-eye spectacle requires close viewing distance

Magnifiers are marked with two strengths

X power
how many times bigger than normal it makes things look
the power of a lens equal to 100 divided by its focal length measured in centimeter

Components of Low Vision Evaluation

1. Interview (e.g COPM)
2. Home Assessment
3. Vision­-re­lated client questi­onn­aires (e.g. symptom manage­ment)
4. Impair­men­t-based assess­ments ( e.g. BIVABA, MN Read, Lea Number, etc)
5. Perfor­man­ce-­based assessment (e.g. ADL and IADL
6. Skilled observ­ations

The Pepper Test (Visual Skills for Reading)

This test was designed to be used with patients who have macular loss
It has both letters and words
A much wider test format so it shows scanning patterns
as you progress with the test, the words get longer and closer together
The test starts at 4M and goes to 1M

The Pepper Test image

The Pepper Test (Visual Skills for Reading)

This test was designed to be used with patients who have macular loss
It has both letters and words
A much wider test format so it shows scanning patterns
as you progress with the test, the words get longer and closer together
The test starts at 4M and goes to 1M

Using Alternate Senses

When one sense starts failing, it is good to start using other senses
Touch and hearing are the senses most substi­tuted for sight
Placing bump dots on applia­nces, locks, and plugs
Listening to get cues is a great substi­tution for vision
Smell is very useful to identify products


contrast sensit­ivity is the ability to distin­guish of light and dark
reduced contrast sensit­ivity is part of aging
increasing contrast can greatly improve what a client can see
simply placing a dark placemat under a white plate can make the plate more visible

Simple Contrast Modifi­cations

Adding contrast makes a difference in how someone sees
Marking step edges with bright color tape can help clients feel safer
Adding contra­sting tape to grab bars improves visibility
Simply changing the color of the plate used can allow someone to see the edge of their plate
Adding contrast to doorways and light switches makes them easier to see (dark-­colored trim against a white wall

Basic Principles of Organi­zation

1. Unclut­tered background is the best
2. Fewer patterns are best
3. Try not to move things
4. Keep pathways clear

MN Read Chart

This is a standa­rdized test that measures acuity and reading speed
The test consists of a series of sentences in varying sizes from 8M to 0.13M
Timed test with odd sentences to ensure the client isn't guessing
Test comes with a scoring graph that will help you determine the client's reading acuity and critical print size. This is the smallest size print a client can read at maximum speed

MN Read Chart image

Assessing Contrast and Glare Sensit­ivity

The ability to detect objects as they decrease in contrast from thier backgr­ounds
ETDRS is used for distance contrast
Lea Numbers low contrast flip chart can be used for near contrast sensit­ivity
Mars letter contrast sensit­ivity ( the letters start out very dark and get lighter as the test progre­sses)
Glare sensit­ivity can be tested generally by observ­ation and questi­oning (if you go into some's home and all of the blinds are drawn you can pretty safely assume they are sensitive to glare)


Light 101

As we age our eyes require more light 9presb­yopia
Consider the types of bulbs and different hues of light (incre­asing the wattage of bulbs to the maximum allowed for the fixture will improve safety)
Make sure light doesn't cause glare. (halogen is a very good light with less glare)
Two types of lighting: task light is a specific kind of light for an individual area or task; general lighting lights the whole area

Home Modifi­cation Ideas

Grouping like items together not only makes them easier to find but it also takes less energy to move around the room and obtain.
Label and marking
Some of the things used for marking are rubber bands, bump dots, large print labels, safety pins, puff paint, etc. The goal is that there is some sort of tactile feedback with high contrast if needed. Avoid over marking – just mark what is necessary and most used!
Teaching sighted guides to help get around the house
Educate and empower the patient and family to make modifi­cations around their homes

SK Read

Tests reading perfor­mance of Englis­h-s­peaking clients with central or parace­ntral scotomas (blind spot)
Consists of group of words and letters that have no meaning
You can determine the location of the scotoma by mistakes they make (If they miss the beginning words you can guess that their scotoma is in the left side of their visual field)
This is a timed test and your record number of mistakes and time per section read

SK Read images

Principle of Low VIsion Modifi­cations

Primarily modifying the enviro­nment and occupa­tions
Evaluate clients' perfor­mance and clients' perception of their perfor­mance before you can succes­sfully modify their enviro­nment
For each vision impairment there are different parts of the vision that are affected

Treatment Basics for Low Vision

The main things that can be changed are lighting, contrast, and magnif­ication

Task Lighting Strategies

Task lighting is important for near tasks such as reading and needle­point (a gooseneck lamp with a solid shade is best)
The light should be the opposite of writing hand
light should be behind if possible


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