A vision awareness and self-assessment toolkit
A bridge to low-vision services and vision rehabilitation

  • Why the toolkit?
  • The tests
  • Awareness education

Why the toolkit?

Remaining unaware of the existence of or the extent of their vision problems or assuming them to be the inevitable result of aging, patients too often:

  • do not seek appropriate eye care.
  • do not seek help after irreparable damage has already been done.
  • do not report their vision problems to their doctor.
  • do not seek rehabilitative support even when the problems are recognized,

With the insights one gains from using the toolkit, patients will be more likely to seek:

  • appropriate medical care at an early date.
  • appropriate rehabilitative care for irreversible losses.


The tests available summer 2016


The most often used vision test is the letter chart test for visual acuity. This is a valid test, but it tests only the tiny retinal area where the letter read is projected. Even in persons with 20/200 acuity (“legal blindness”), this area is less than one degree in diameter.

Today, the most common causes of vision loss are Age-Related Macular Degeneration (AMD), glaucoma and diabetic retinopathy. In all three, the condition of different retinal areas may vary significantly. So, sampling only a small retinal area is no longer sufficient.

Three tests in one

Rather than providing separate tests for different visual functions, such as visual acuity, contrast sensitivity and visual field, the visual search test will be comprised of all three components in one test. The test is based on prior research at the Smith-Kettlewell Eye Research Institute in San Francisco, which has shown that prolonged search times are strongly indicative of the presence of absolute or relative blind spots (scotomata) outside fixation. By varying the size and contrast of the stimuli, visual acuity and contrast can also be assessed.

The test is an adaptation of the test Dr. Colenbrander is currently developing as the IVA system for Interactive Vision Assessment. Since the patient responds directly to the computer when stimuli are presented on a computer screen, this system is minimally dependent on trained examiners, and can therefore be easily adapted for in-home testing.

Test modes

Testing for macular and peri-fixational scotomata, as in AMD, advanced glaucoma and diabetic retinopathy will be implemented for both smartphones, tablet computers and PCs.

Because the scotomata are farther from fixation and therefore require a larger screen, testing for Bjerrum scotomata, as in early glaucoma, will be implemented for tablet computers and PCs.

Education and awareness - now available

The website places thetests in the context of how vision becomes impaired by various diseases. Too often those with vision-impairing diseases are unaware of how these diseases manifest and how their treatment may affect functional vision.

Teaching people to use the tests to document their vision changes heightens awareness of their visual capabilities and limitations and empowers them to actively preserve and enhance their abilities to function in the world through vision rehabilitation.

The awareness toolkit is designed to raise awareness of:

  • the stages of visual processing.
  • the stages of vision loss
  • the ways in which glaucoma, macular degeneration, diabetic retinopathy and other conditions each can affect vision.
  • the ways vision loss manifests in functional vision and in activities of daily living. We will use dynamic video imagery, rather than static pictures, to effectively represent how functional vision can be affected.
  • the interpretation of clinical tests in the context of functional vision.
  • ways to become aware of vision loss and adaptation to vision defficiencies.
  • how rehabilitation can alleviate the effects of vision loss.
  • testing functional vision for screening and monitoring vision loss.
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