Amsler grid/ confrontational fields

Question 1

what is the amsler grid an alternative for?

what is its advantage?

Answer 1

alternative to 10° central VF analysis if a quick assessment of macular function is required

they are portable, so can be used for home visits. The recording sheets can be used for home monitoring.

Question 2

what are 4 history taking indications for amsler grid?

Answer 2

1. visual symptoms (i.e. “distorted” vision)
2. patients above 60 years old
3. patients on certain medications (e.g., hydroxychloroquine, ethambutol, etc.)
4. smokers

Question 3

what are 4 ocular findings indications for amsler grid?

Answer 3

drusen within 2 disc diameter - suspect Age-related Macular Degeneration (AMD)

hard exudates around macular region - suspect of Clinically Significant Macular Oedema (CSMO)

epiretinal membrane (ERM)

any suspected macular findings

Question 4

what are the 4 set up steps for amsler chart?

Answer 4

Start with the RE, occlude the LE

NEAR prescription should be used (if applicable)

If patient is wearing PAL, transfer the rx into the trial
frame

Hold the chart at around 30* cm

• Take note: The testing distance can vary between different manufacturers. ALWAYS check the indicated testing distance.

Question 5

what are the instructions for ansler grid?

Answer 5

Explain the purpose of test:

explain the test
“I will be checking your central vision”

6. Ask patient:
   “Can you see the central white dot?”

“Keep looking at the central white dot, can you still see the 4 corners of the large square?”

“Still looking at the central white dot, is any of the lines appear wavy or distorted?”

Question 6

what is normal recording for px?

Answer 6

no wavy or distorted lines observed

Question 7

what are some abnormal recording for px?

Answer 7

If scotomas are noted, the patient is asked to describe, show and draw the “defect” location on the chart.

Patient’s remarks about the appearance and depth of the scotoma are added.

Comments about the result’s reliability based on the patient’s characteristics and expressions are noted as well (e.g. patient has difficulty locating the central dot)

The grid should be labelled (i.e. RE/LE, name), dated and attached to the patient’s record.