Name: ________________________________________
Date: _________________________________________
Procedure 38-3:
Assessing and Recording Color Vision Acuity Using the Ishihara Test
Objective: Screen a patient for color vision defects.
Equipment and Supplies: Ishihara screening book/cards; paper and pen
Affective Behaviors: Affective behaviors provide a professional approach to a skill that enhances
the patient encounter. These behaviors may also display sensitivity to a patient’s rights and
enhance communication. Pay close attention to these skills, which will be in bold, italicized font.
Skills Assessment Requirements
Read and familiarize yourself with the procedure. Complete each procedure within a reasonable
amount of time, with a minimum of 85% accuracy.
Documentation
Use the area below for any documentation needed to complete the procedure.
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GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
1. Perform hand hygiene.
2. Review the physician’s order.
3. Assemble equipment.
4. Identify the patient and
introduce yourself.
5. Explain the procedure.
6. Have the patient assume a
comfortable position, and ask the
patient to keep both eyes open.
7. In a well-lit room, have the
patient identify, at a distance
of 30 inches, the number that
is formed by the colored dots
on each card or page within
three seconds per page or card.
8. If the patient is unable to
identify the numbers, have the
patient trace the number with a
finger.
9. Score each plate as it is read.
(Figure 38-3 is an example of
one color plate.) If the patient is
able to identify the number, then
record the number seen after the
plate number (e.g., Plate 1:7). If
the patient was unable to identify
a number on a plate, record the
plate number and mark an X next
to it.
POINT VALUE
= 3–6 points
= 7–9 points
Name: ________________________________________
Date: _________________________________________
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GRADED
TRIAL
# 1
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NOTES
10. Note any unusual symptoms.
11. Document the results accurately.
GRADING
Points Earned
Points Possible 84 84
Percent Grade (Points Earned/
Points Possible)
PASS: YES
NO
N/A
YES
NO
N/A
Instructor Sign-O
Instructor: ______________________________________________ Date: _________________________
POINT VALUE
= 3–6 points
= 7–9 points
Name: ________________________________________
Date: _________________________________________
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