What chart should be used if a patient has a central scotoma?

What chart should be used if a patient has a central scotoma?

• A. Snellen Chart
• B. Bailey-Lovett Chart
• C. Feinbloom Chart With Single Optotype
• D. ETDRS Chart

Answer: (C)

When central vision is compromised by a central scotoma, acuity testing should minimize crowding and rely on recognizing a single target. The Feinbloom Chart With Single Optotype is designed for this situation: it presents one optotype per line, at varying sizes, with high contrast, so the patient identifies a single target rather than parsing a whole row of letters. This reduces interference from surrounding letters and yields a more reliable measure of what the patient can see with their central vision. Other charts, like the standard Snellen chart with multiple letters per line or the ETDRS chart with several optotypes per line, rely more on crowding and letter recognition in a line, which can be confounded by a central scotoma. Bailey-Lovett charts use symbols and aren’t tailored to isolating a single target in central vision loss.

When central vision is compromised by a central scotoma, acuity testing should minimize crowding and rely on recognizing a single target. The Feinbloom Chart With Single Optotype is designed for this situation: it presents one optotype per line, at varying sizes, with high contrast, so the patient identifies a single target rather than parsing a whole row of letters. This reduces interference from surrounding letters and yields a more reliable measure of what the patient can see with their central vision. Other charts, like the standard Snellen chart with multiple letters per line or the ETDRS chart with several optotypes per line, rely more on crowding and letter recognition in a line, which can be confounded by a central scotoma. Bailey-Lovett charts use symbols and aren’t tailored to isolating a single target in central vision loss.