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Medical Forum / General / Vision / September 2006

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Can distance to eye chart be compensated for by character size on Snellen Chart?

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Bob Peyton - 25 Sep 2006 23:29 GMT
The opthalmology clinic I visit has recently moved into new offices.  In the
old office refraction for prescribing eyeglasses was done at a distance of
(I assume)  20'.  This was accomplished with the usual
projector/screen/mirror system to achieve the desired eye-to-chart distance,
since the examining room dimension was less than 20'.  The new offices use a
computer-driven LCD screen viewed directly from a distance of about 7 feet.
I asked the techician who was actually doing the refraction if this produced
accurate results and she assured me that it did, since the computer adjusted
the size of the letters in the chart to compensate for the shorter viewing
distance.  Nevertheless, a recent refraction and a re-refraction have both
produced Rx that yielded blurred distance vision, but which are really good
for TV viewing at ~10'.  The optician says the glasses were made to
prescription and the clinic agrees.  Refractions done at the old office were
satisfactory.

I have IOL's in both eyes (since 1990), thus no distance accomodation.
IIRC, shortly after the IOL's were inserted my vision was sharpest at about
6 to 7 feet.  At that time I needed trifocals for distance vision and
reading/computer work.  Over time, my sharpest vision distance has decreased
to about 14".

Is it reasonable to believe that a Rx measured at ~7' will produce good long
distance vision, especially with IOL's?  Is it possible that the Rx measured
at 7' could be mathematically adjusted to provide better long distance
results?

Current Rx:

               SPH            CYL            AXIS            ADD
OD        -1.50            +1.50            173            +2.50
OS        -1.75            +1.00            009            +2.50

Lenses are progressive "Transitions".

Thanks to any and all who reply,

Bob Peyton
Jan - 26 Sep 2006 00:17 GMT
Bob Peyton schreef:
> The opthalmology clinic I visit has recently moved into new offices.  In the
> old office refraction for prescribing eyeglasses was done at a distance of
[quoted text clipped - 6 lines]
> the size of the letters in the chart to compensate for the shorter viewing
> distance.

You can compensate for the shorter distance, in your example you have to
add  about -0,5 diopters since you have no abilities to accommodate.

7 feet is the same as about 2 meters I think and this results in 1/2=
0,5dpt which has to be compensated for the far distance.

The adjustment in size of the characters is only done to assure the
correct vision acuity can be notated.

However, refraction on such a short distance is NOT DONE for several
reasons, i.e. accommodation, binoculair vision related issues etc..

The only one who is measuring the visus (vision acuity) this way is that
horrible layman Otis.

Jan (normally Dutch spoken)
otisbrown@pa.net - 26 Sep 2006 00:22 GMT
The "official" distanc has always been 20 feet or 6 meters, which
was considered to be optical "infinity".

Ten feet is probably a reasonable compromise.  But less
that 10 feet -- well...

If they are prescribing for 7 feet, then the result will
most probably be an under-prescription of 1/4 to 1/2 diopter.

If you wish to check this yourself, I have a nifty IVAC Snellen
on my site at:

www.myopiafree.com

that you can check at 20 feet.

If you read the 20/20 line (1/2 the letters correctly) then you
can confirm that your prescription meets that standard.

Enjoy,

Otis

> The opthalmology clinic I visit has recently moved into new offices.  In the
> old office refraction for prescribing eyeglasses was done at a distance of
[quoted text clipped - 33 lines]
>
> Bob Peyton
Dan Abel - 26 Sep 2006 01:03 GMT
> The opthalmology clinic I visit has recently moved into new offices.  In the
> old office refraction for prescribing eyeglasses was done at a distance of
[quoted text clipped - 6 lines]
> the size of the letters in the chart to compensate for the shorter viewing
> distance.

My old OD had a 20 foot exam room.  The layout was a little weird, but I
liked it.

> Is it reasonable to believe that a Rx measured at ~7' will produce good long
> distance vision, especially with IOL's?

No.

> Is it possible that the Rx measured
> at 7' could be mathematically adjusted to provide better long distance
> results?

Jan has replied to this.  I am not impressed with the idea of using a
"fudge factor" when testing my distance vision.  Perhaps 7 feet is good
enough, but I know that making the letters really tiny at a distance of
18 inches is not a good test of my distance vision.

Signature

Dan Abel
dabel@sonic.net
Petaluma, California, USA

 
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