Certified Ophthalmic Assistant Practice Exam

If a patient cannot identify the largest letter on a Snellen chart, what should the assistant do next?

1. Move closer to the patient

2. Determine if the patient can see fingers at a specific distance

3. Switch to a different chart

4. Ask the patient to cover one eye

The correct answer is: Determine if the patient can see fingers at a specific distance

The correct approach is to determine if the patient can see fingers at a specific distance. This step is essential because it helps to assess the patient's visual acuity in a more controlled way when they can't identify the largest letters on the Snellen chart. By checking whether the patient can see a hand moving or fingers at a designated distance, the assistant gains valuable information about the level of vision and can further evaluate how severe the vision impairment might be. This method also helps to establish a baseline for further testing, and it's useful in identifying potential issues that may not be apparent through chart reading alone. While other options may be useful in different situations, they do not provide the same clarity about the patient's visual capabilities. For instance, moving closer to the patient might not yield better results and can lead to a misinterpretation of the patient's visual acuity. Switching to a different chart might also not be appropriate since the concern is identifying basic visual perception rather than issues with the chart itself. Covering one eye can help further isolate vision problems, but first determining the ability to see fingers helps confirm the extent of the visual loss.