1. ✦ Assemble equipment.
2. ✦ Review physician’s order.
3. ✶ Perform hand hygiene and
identify the patient.
4. ✶ Explain the procedure.
5. ✶ Determine the patient’s ability
to recognize letters. If the patient
is unable to read letters, use the
necessary chart to accommodate
the patient’s abilities.
6. ✦ Place the patient 20 feet from the
chart, either seated or standing,
as long as the Snellen eye chart is
at eye level (Figure A).
7. ✦ Follow oce policy regarding
testing with or without corrective
8. ✦ Following oce policies regarding
which eye to test ﬁrst, have the
patient cover the other eye with
a cup or occluder. The occluder
should be held in such a way so
as not to interfere with the normal
position of a patient’s glasses.
9. ✦ Instruct the patient to keep
both eyes open even though
one eye is covered. Have the
patient read the lines with both
eyes ﬁrst at a distance of 20 feet.
10. ✦ Use a pointer and point to letters
or appropriate symbols in random
11. ✶ Starting with the 20/70 line, ask
the patient to identify each line
and proceed down the chart to
the last line the patient can read
without error. Observe for signs of
squinting or tilting the head, which
indicate diculty identifying letters.
✦ = 3–6 points
✶ = 7–9 points
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