The eye is the one organ where “looks fine” is never charting. Acuity is measured with a chart and written as a fraction; pupils are written in millimetres, not as the word “equal.” Enter real numbers here, read what they actually mean, and then decide which eye findings are charted and which ones are called.
Test each eye separately with the other covered by an occluder or the patient’s palm — never their fingers, because patients peek. Then test both together. Glasses or contacts for distance stay on, and the result is charted as corrected.
Correction worn during the test
Visual fields by confrontation
Confrontation, done properly. Sit facing the patient at eye level about 60 cm (2 feet) away. Cover your right eye, have them cover their left, keep your eyes locked, and bring a wiggling finger in from the far periphery of each of four quadrants, midway between you. You are the control — you should both see it at the same instant. Normal fields extend roughly 50° superiorly, 60° nasally, 70° inferiorly and 90° temporally.
Right pupil — 4 mm
Left pupil — 4 mm
Reaction to light
Level of consciousness
Is this difference new?
Any of these with it?
Pick a finding, then choose the action
Three choices only: chart and reassess, notify the provider, or act now. Getting it wrong is how vision is lost.
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Correct
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Attempted
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Findings
Measure it, number it, side itEnter acuity on the left and this panel translates it.