BERKELEY RUDIMENTARY VISION TEST

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Patient
Age BERKELEY RUDIMENTARY VISION TEST
Do not write on Tested by
Date Letter Chart Visual Acuity and its limitations
thi page.
this Eye Clinical measurement of visual acuity is usually made with charts of letters or other optotypes. In 1976, Bailey and Lovie
C lC
Causal diti
Condition introduced a set of principles for the design of visual acuity charts that caused size to become the only significant variable
from one size level to the next. This requires a size progression by a constant ratio, the same number of letters at each size
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Photocopy l
only. level, and the spacings between adjacent rows and adjacent letters should be proportional to letter size. Each size level
should contain a mix of optotypes that are balanced for difficulty. With this chart design came the LogMAR scale for
RIGHT LEFT measuring visual acuity, and the system of assigning equal LogMAR points for every additional letter read correctly.
Such “LogMAR” chart designs are now widely used, and the ETDRS letter chart has become accepted as the gold standard
Previous VA Previous VA
for visual acuity measurement. The ETDRS chart uses the set of 10 Sloan Letters as its optotype, but there are many other
Clin Record
LogMAR charts that use other optotypes (e.g., Tumbling E’s, Landolt Rings, numbers and pictures).
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Referrall lletter
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Self report
The recommended viewing distance for the ETDRS chart is 4 meters, but other charts use other test distances such as 6 m, 3
Other
m, 20 ft and 10 ft. The patient’s task is to read each row in sequence beginning with the largest size at the top, and
progressing to the smaller sizes until the letters can no longer be correctly identified.
TESTING WITH BRVT The patient should be able to at least read across the top row of the chart, and also be unable to read the row with the smallest
if NO
print at the bottom of the chart. Then, the patient’s visual acuity limit lies within the measurement range of the chart.
STE 25 M at 1m (Y/N)
If STE 25M seen at 1m THEN Test Letter Chart Acuity There is, however, a limit to the poorest visual acuity that can be measured with a LogMAR chart. At 1 meter, the 40 M
if NO STE 25M at 4m (Y/N) letter size subtends 200 minarc (3.3º) and the angular width of the row is 30º. The visual acuity for this angular size is
Letter Chart VA at 4m LogMAR = 1.6, (VAR = 20, 1/40, 6/240, 20/800, 0.025)
For visual acuity levels beyond the limit of the letter chart, the common practice is for clinicians to categorize vision
L
Letter Chart
Ch VA at 1
1m according to whether the patient can count fingers (CF) or detect hand motion (HM), but there are no recognized or standard
procedures for doing this.
if STE 100M at 1m (Y/N)
100M STE @ 1m 2.020 The Berkeley Rudimentary Vision Test (BRVT) was developed to enable efficient and easy measurement of
63M STE @ 1m 1.8
18 visual acuity beyond the limits of the letter chart. It becomes necessary to make the test task simpler than the letter chart task
40M STE @ 1m 1.6 and, in order to achieve very large angular sizes, very close viewing distances may be required. In the interests of simplicity
25M STE @ 1m 1.414 and flexibility of use, the BRVT has 3 card-pairs. Each card-pair consists of two 25 cm square hinged cards, so each card-
pair has 4 target surfaces.
if NO STE 100M at 25cm (Y/N)
100M STE @ 11m 2.6
26 SINGLE TUMBLING E CARD-PAIR: used at viewing distances of either 1 meter or 25 cm.
63M STE @ 1m 2.4 This has 4 Single Tumbling E’s as the test targets. The STE letter sizes are 100M and 25M on the outsides, and 63M and
40M STE @ 1m 2.2
22 40M on the insides. The patient identifies the direction in which the legs of the E are pointing. (up, down, right, left)
25M STE @ 1m 2.0
At 1 meter, the STE visual acuity levels are STE LogMAR = 2.0. 1.8, 1.6 and 1.4
if NO (VAR = 0 to 30, 6/600 to 6/150, 20/2000 to 20/500, or 0.01 to 0.04)
60mm GA @ 25 cm (Y/N)
60 ( ) At 25 cm, the STE visual acuity levels are STE LogMAR=2.6. 2.4, 2.2 and 2.0
200M GA @ 25 cm 2.9
29 (VAR = -30 to 0, 6/2400 to 6/600, 20/8000 to 20/2000, or 0.0025 to 0.01)
125M GA @ 25 cm 2.7
27
80M GA @ 25 cm 2.5 GRATING ACUITY CARD-PAIR: used only at a viewing distance of 25 cm.
50M GA @ 25 cm 2.3
23 This has 4 gratings as the test targets. The size of the stripes are 200M and 50M (60 &15 mm) on the outsides, and 125M
and 80 M (38 & 24 mm) on the insides. The patient identifies the orientation of the stripes. (horizontal or vertical)
if NO White Field Projection
Quad At 25 cm, the Grating Acuity levels are GA LogMAR=2.9. 2.7, 2.5 and 2.3
Hemi (VAR = -45 to -15, 6/4800 to 6/1200, 20/16000 to 20/4000, 0.00125 to 0.005, or 0.038 to 0.15 cpd)
COMMENT
BASIC VISION CARD-PAIR: used only at a viewing distance of 25 cm.
if NO Black White Discrimination
Black - White
Black White Discrimination (BWD)
COMMENT
When folded one way, one of the card surfaces is all black, and the reverse side is all white.
This tests whether the patient can discriminate an all-black from an all-white field of this angular size (53º square)
Manufactured by: Lght Perception White Field Projection (WFP)
When folded the other way, one card face is half-black and half-white, and the other card face is black with one white
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Light
ght Perceived
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quadrant. This tests whether the patient can identify the direction or location of the white field as being to the left, right, top
or bottom for the 26º wide hemi-field, or the 26º square quad-field.
RESULT
Berkeley Rudimentary Vision Test
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 VISUAL ACUITY CONVERSION TABLE
BERKELEY RUDIMENTARY VISION TEST SNELLEN Letter Chart Single Tumbling E's Gratings Basic Vision Light Distances
LogMAR VAR 20/.. 6/… 4/.. Decimal 4 meters 1 meter 1 meter 25 cm 25 cm 25 cm Perception to Diopters
-0.3 115 10 3 2.0 2.0 LC VA cm D
PROCEDURES -0.2 110 12.5 3.8 2.5 1.6 LC VA 100 1.00
-0.1 105 16 4.8 3.2 1.3 LC VA 80 1.25
Should the visual acuity be measured with a letter chart? 0.0 100 20 6 4.0 1.0 LC VA 63 1.60
0.1 95 25 7.5 5.0 0.80 LC VA 50 2.00
Use the Single Tumbling E Card-Pair, and present the 25 M STE at a viewing distance of 1 meter.
If the 25 M STE CAN be correctly identified at 1 m , then Letter Chart Visual Acuity measurement should be attempted. 0.2 90 32 9.5 6.3 0.63 LC VA 40 2.50

The letter chart could be presented with a viewing distance of 1 meter, or at a longer distance (e.g., 4 meters). 0.3 85 40 12 8.0 0.50 LC VA LC VA 32 3.25
Typically, the longer test distance be the standard distance used by the clinician when testing with letter charts. 0.4 80 50 15 10 0.40 LC VA LC VA 25 4.00
0.5 75 63 19 12.5 0.32 LC VA LC VA 20 5.00
0.6 70 80 24 16 0.25 LC VA LC VA 16 6.25
Should vision be measured with the BRVT? 0.7 65 100 30 20 0.20 LC VA LC VA 12.5 8.00
If the 25 M STE CANNOT be correctly identified at 1 meter, then the BRVT series of tests should be employed. 0.8 60 125 38 25 0.16 LC VA LC VA 10 10.00
0.9 55 160 48 32 0.125 LC VA LC VA 8 12.50
Single Tumbling E Card-Pair, presented at a viewing distance of 1 meter. 1.0 50 200 60 40 0.100 LC VA LC VA 6.3 16.00
If the 100M STE CAN be correctly identified at 1 meter, then visual acuity measurement is completed with the STE at 1 m. 1.1 45 250 75 50 0.080 LC VA 5 20.00
The visual acuity levels are STE LogMAR = 2.0, 1.8, 1.6 and 1.4 1.2 40 320 95 63 0.063 LC VA 4 25.00
If the 100M STE CANNOT be correctly identified at a viewing distance of 1 meter, then the viewing distance 1.3 35 400 120 80 0.050 LC VA 3.2 32.00
should be shortened to 25 cm. (This corresponds to the width of the cards.) 1.4 30 500 150 100 0.040 LC VA STE VA 2.5 40.00
1.5 25 630 190 125 0.032 LC VA 2 50.00
Single Tumbling E Card-Pair, presented at a viewing distance of 25 cm. 1.6 20 800 240 160 0.025 LC VA STE VA
If the 100M STE CAN be correctly identified at 25 cm, visual acuity measurement is completed with the STE at 25 cm. 1.7 15 1000 300 200 0.020
The visual acuity levels are STE LogMAR = 2.6, 2.4, 2.2 and 2.0 1.8 10 1250 380 250 0.016 STE VA
If the 100M STE CANNOT be correctly identified at a viewing distance of 25 cm, then a simpler test target is required, 1.9 5 1600 480 320 0.0125
and now the Grating Acuity Card-Pair is presented, at a viewing distance of 25 cm. 2.0 0 2000 600 400 0.010 STE VA STE VA
2.1 -5 2500 750 500 0.008

Grating Acuity Card-Pair, presented at a viewing distance of 25 cm. 2.2 -10 3200 950 630 0.0063 STE VA
2.3 -15 4000 1200 800 0.005 GA
If the 200M GA target (60 mm stripes) CAN be correctly identified at 25 cm, visual acuity measurement is completed with
2.4 -20 5000 1500 1000 0.004 STE VA
the GA targets at 25 cm.
The visual acuity levels are GA LogMAR = 2.9, 2.7, 2.5 and 2.3 2.5 -25 6300 1900 1250 0.0032 GA
If the 200M GA target CANNOT be correctly identified at a viewing distance of 25 cm, then measurement of 2.6 -30 8000 2400 1600 0.0025 STE VA
visual resolution is abandoned, and the Basic Vision Card Pair is used at a viewing distance of 25 cm. 2.7 -35 10000 3000 2000 0.002 GA
2.8 -40 12500 3800 2500 0.0016
2.9 -45 16000 4800 3200 0.00125 GA
Basic Vision Card-Pair, presented at a viewing distance of 25 cm. 3.0 -50 20000 6000 4000 0.001
If the Black White Discrimination Task (BWD) CAN be successfully completed, then the White Field Projection 3.1 -55
(WFP) task should be presented at 25 cm. 3.2 -60 WFP
With this card-pair, vision may be categorized as WFP or BWD
3.3 -65
If the Black White Discrimination Task (BWD) CANNOT be successfully completed
3.4 -70
then, Light Perception should be tested.
3.5 -75 BWD
3.6 -80
Light Perception. 3.7 -85
With a penlight, or similar, held close to the eye, can the presence or absence of the light be correctly identified? 3.8 -90
Vision may be classified as Light Perception or No Light Perception LP or NLP 3.9 -95 LP
4.0 -100 NLP

MAR = Minumum Angle of Resolution:

Berkeley Rudimentary Vision Test
By convention, it is taken to be one fifth of the height of the optotype, and expressed in minutes of arc.
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For 20/20, MAR = 1 minarc : For 20/200, MAR = 10 minarc :

LogMAR = Log10(MAR) For 20/20, LogMAR = 0.0 : For 20/200, LogMAR =1.0 :

VAR = 100 - 50xLogMAR : For 20/20, VAR = 100 : For 20/200, VAR = 50 :
VAR is a convenient transform of the LogMAR scale. It is one point per letter on "LogMAR" charts

Decimal notation is the reciprocal of the Snellen fraction. For 20/20, Decimal = 1.0 : For 20/200, Decimal = 0.10 :

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