Test Questions and Referral Guide
Notes: All tests are given with both eyes open at all times. Subject to wear any glasses normally used for driving.
Test #1 Quick Acuity at 20/40 Level
Actual Test
| QUICK ACUITY TEST |
| |
| BOTH | RIGHT | LEFT |
1. | 958 | 479 | 823 |
2. | 347 | 563 | 268 |
3. | 426 | 728 | 534 |
Ask your subject: “ Do you see three columns with numbers?” “Look at the first column, starting from top to bottom, please read the digits to me.” “Now the second column, an the third column, please?”
Referral: If more than two digits in any column are missed
Test #2 Color Deficiency
Actual Test
COLOR
4163
Ask your subject: “ Do you see four blocks with
Referral: If at least two numbers are misread.
5