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Questions and Answers
What should be ensured before conducting the Amsler test?
What should be ensured before conducting the Amsler test?
Which symptom should a patient report while looking at the central dot during the Amsler test?
Which symptom should a patient report while looking at the central dot during the Amsler test?
What should be avoided when recording results from the Amsler test?
What should be avoided when recording results from the Amsler test?
What is a significant limitation of the Amsler test?
What is a significant limitation of the Amsler test?
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Which method is recommended for ongoing monitoring after an Amsler test?
Which method is recommended for ongoing monitoring after an Amsler test?
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What is the primary purpose of the Amsler chart?
What is the primary purpose of the Amsler chart?
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Which of the following symptoms would indicate a need to use the Amsler chart?
Which of the following symptoms would indicate a need to use the Amsler chart?
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Which Amsler chart is preferred for detecting central scotomas?
Which Amsler chart is preferred for detecting central scotomas?
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How should the Amsler chart be held during the test?
How should the Amsler chart be held during the test?
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What does the use of Chart 3 enhance the detection of?
What does the use of Chart 3 enhance the detection of?
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Which condition is most likely to be monitored using the Amsler chart?
Which condition is most likely to be monitored using the Amsler chart?
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What feature does Chart 5 have that assists in detecting certain visual changes?
What feature does Chart 5 have that assists in detecting certain visual changes?
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Why is it essential to test monocularly with the Amsler chart?
Why is it essential to test monocularly with the Amsler chart?
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Study Notes
Amsler Chart Introduction
- Introduced in 1945 to assess macular function.
- A static visual field test allowing simultaneous viewing of the stimulus across the tested area.
- Assesses a 10-degree area around fixation.
- Useful for detecting metamorphopsia (distortion) and scotomas in the macular area.
- Available as a book with plates and separate recording sheets for patient self-monitoring.
Amsler Chart Types and Uses
- Charts 1-7 offer variations for detecting different pathologies.
- Chart 1 is most commonly used, detecting scotomas and metamorphopsia; each square subtends 10° of the visual field.
- Chart 2 adds diagonal lines to aid fixation and localization of defects, particularly useful with central scotomas.
- Chart 3 (red on black) enhances detection of toxic maculopathy due to drugs and optic nerve disorders.
- Chart 4 uses a random dot pattern to isolate scotomas since metamorphopsia won't affect the pattern.
- Charts 5, 6, and 7 offer variations in line orientation, spacing, and square size for detecting subtle defects and metamorphopsia along specific meridians.
When to Use Amsler Charts
- Unexplained reduced visual acuity.
- Symptoms of distortion.
- Suspected age-related macular degeneration (AMD).
- Patients on medications affecting the macula (e.g., chloroquine, hydroxychloroquine, tamoxifen).
- Always test monocularly.
Amsler Chart Technique
- Explain the test to the patient.
- Patient should wear near correction (if any).
- Occlude one eye (monocular testing).
- Hold the chart at 28-30 cm.
- Ensure even illumination.
- Ask the patient if they can see all four corners of the square, if lines are straight, and if any areas are missing while fixating on the central dot (starting with Chart 1 and moving to Chart 2 if needed).
Recording Amsler Chart Results
- Ask patients to draw what they see on recording charts.
- Older patients may need to describe defects.
- Do not use recording charts instead of the Amsler chart.
- Always use the 'white on black' versions initially.
- Record the eye tested and add a description.
Amsler Chart Results and Limitations
- Results show a variety of appearances.
- Low sensitivity (9% in early AMD, 34% in choroidal neovascularization) leads to a high false-negative rate.
- Often replaced by OCT, but useful as a self-monitoring tool for patients to use weekly to detect changes.
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Description
Explore the significance of the Amsler Chart, introduced in 1945 to assess macular function. This quiz covers its various types and uses in detecting pathologies like scotomas and metamorphopsia, along with patient self-monitoring techniques.
