[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.00,0:00:05.43,Default,,0000,0000,0000,,
Dialogue: 0,0:00:05.43,0:00:08.60,Default,,0000,0000,0000,,Teller Acuity Cards\Nare used to test visual acuity
Dialogue: 0,0:00:08.60,0:00:11.20,Default,,0000,0000,0000,,in young children\Nand those with disabilities
Dialogue: 0,0:00:11.20,0:00:13.27,Default,,0000,0000,0000,,who cannot be tested\Nwith standard letter
Dialogue: 0,0:00:13.27,0:00:16.07,Default,,0000,0000,0000,,or symbol acuity tests.
Dialogue: 0,0:00:16.07,0:00:18.23,Default,,0000,0000,0000,,The stimulus\Non a Teller Acuity Card
Dialogue: 0,0:00:18.23,0:00:20.73,Default,,0000,0000,0000,,is a high contrast black\Nand white pattern
Dialogue: 0,0:00:20.73,0:00:23.10,Default,,0000,0000,0000,,of stripes called a grating.
Dialogue: 0,0:00:23.10,0:00:25.17,Default,,0000,0000,0000,,
Dialogue: 0,0:00:25.17,0:00:28.47,Default,,0000,0000,0000,,The gratings range\Nfrom very coarse to very fine,
Dialogue: 0,0:00:28.47,0:00:30.13,Default,,0000,0000,0000,,in order to test visual acuity
Dialogue: 0,0:00:30.13,0:00:32.67,Default,,0000,0000,0000,,from very low vision to normal.
Dialogue: 0,0:00:32.67,0:00:34.17,Default,,0000,0000,0000,,
Dialogue: 0,0:00:34.17,0:00:36.87,Default,,0000,0000,0000,,Most rectangular cards\Nhave a single grating
Dialogue: 0,0:00:36.87,0:00:39.43,Default,,0000,0000,0000,,printed off to one side\Nof the center.
Dialogue: 0,0:00:39.43,0:00:41.83,Default,,0000,0000,0000,,Printing the grating\Nto one side of the card
Dialogue: 0,0:00:41.83,0:00:44.67,Default,,0000,0000,0000,,allows it to be presented either\Non the left
Dialogue: 0,0:00:44.67,0:00:45.87,Default,,0000,0000,0000,,or the right.
Dialogue: 0,0:00:45.87,0:00:46.93,Default,,0000,0000,0000,,
Dialogue: 0,0:00:46.93,0:00:47.80,Default,,0000,0000,0000,,An additional card
Dialogue: 0,0:00:47.80,0:00:51.10,Default,,0000,0000,0000,,has a grating nearly covering\None-half of the card.
Dialogue: 0,0:00:51.10,0:00:54.20,Default,,0000,0000,0000,,This card\Nis called the low vision card.
Dialogue: 0,0:00:54.20,0:00:56.17,Default,,0000,0000,0000,,
Dialogue: 0,0:00:56.17,0:01:00.27,Default,,0000,0000,0000,,The final card is a blank, gray card\Nwithout a grating.
Dialogue: 0,0:01:00.27,0:01:01.33,Default,,0000,0000,0000,,
Dialogue: 0,0:01:01.33,0:01:03.13,Default,,0000,0000,0000,,Grating values are specified
Dialogue: 0,0:01:03.13,0:01:06.30,Default,,0000,0000,0000,,by the width\Nof their black and white bars.
Dialogue: 0,0:01:06.30,0:01:10.40,Default,,0000,0000,0000,,A single black and white pair\Nof bars is called a cycle.
Dialogue: 0,0:01:10.40,0:01:12.00,Default,,0000,0000,0000,,Grating sizes are specified
Dialogue: 0,0:01:12.00,0:01:15.20,Default,,0000,0000,0000,,by the number of black\Nand white cycles per centimeter.
Dialogue: 0,0:01:15.20,0:01:16.47,Default,,0000,0000,0000,,
Dialogue: 0,0:01:16.47,0:01:18.37,Default,,0000,0000,0000,,The metric cycles per centimeter
Dialogue: 0,0:01:18.37,0:01:21.40,Default,,0000,0000,0000,,is converted to visual acuity based\Non the distance
Dialogue: 0,0:01:21.40,0:01:24.40,Default,,0000,0000,0000,,of the Teller Acuity Card grating\Nfrom the patient,
Dialogue: 0,0:01:24.40,0:01:28.10,Default,,0000,0000,0000,,and is specified as cycles\Nper degree.
Dialogue: 0,0:01:28.10,0:01:31.33,Default,,0000,0000,0000,,The cycles per degree measure\Nis the appropriate specification
Dialogue: 0,0:01:31.33,0:01:33.13,Default,,0000,0000,0000,,for grating acuity.
Dialogue: 0,0:01:33.13,0:01:34.40,Default,,0000,0000,0000,,
Dialogue: 0,0:01:34.40,0:01:37.37,Default,,0000,0000,0000,,If necessary,\Ngrating acuity can be converted
Dialogue: 0,0:01:37.37,0:01:39.70,Default,,0000,0000,0000,,into conventional Snellen notation,
Dialogue: 0,0:01:39.70,0:01:42.57,Default,,0000,0000,0000,,which may be more appropriate\Nfor certain reporting.
Dialogue: 0,0:01:42.57,0:01:44.47,Default,,0000,0000,0000,,
Dialogue: 0,0:01:44.47,0:01:47.13,Default,,0000,0000,0000,,Each Teller Acuity Card\Nhas labels on the back
Dialogue: 0,0:01:47.13,0:01:49.100,Default,,0000,0000,0000,,showing the grating size\Nin cycles per centimeter,
Dialogue: 0,0:01:50.00,0:01:54.37,Default,,0000,0000,0000,,and the conversions to acuity based\Non three test distances.
Dialogue: 0,0:01:54.37,0:01:56.53,Default,,0000,0000,0000,,The labels on the back\Nof the card are placed
Dialogue: 0,0:01:56.53,0:01:58.43,Default,,0000,0000,0000,,so the examiner has no information
Dialogue: 0,0:01:58.43,0:02:00.53,Default,,0000,0000,0000,,about the right-left position\Nof the grating
Dialogue: 0,0:02:00.53,0:02:03.40,Default,,0000,0000,0000,,from viewing the back of the card.
Dialogue: 0,0:02:03.40,0:02:05.93,Default,,0000,0000,0000,,The primary principle\Nof a Teller Acuity Card
Dialogue: 0,0:02:05.93,0:02:08.77,Default,,0000,0000,0000,,is that if a patient sees a grating\Non the grey background,
Dialogue: 0,0:02:08.77,0:02:11.20,Default,,0000,0000,0000,,she will look at the grating.
Dialogue: 0,0:02:11.20,0:02:14.63,Default,,0000,0000,0000,,If the grating bars cannot be resolved\Nor seen by a patient,
Dialogue: 0,0:02:14.63,0:02:17.20,Default,,0000,0000,0000,,the grating should match\Nthe grey background perfectly,
Dialogue: 0,0:02:17.20,0:02:19.27,Default,,0000,0000,0000,,mimicking the blank card.
Dialogue: 0,0:02:19.27,0:02:20.47,Default,,0000,0000,0000,,
Dialogue: 0,0:02:20.47,0:02:23.60,Default,,0000,0000,0000,,The examiner's task\Nin testing Teller Acuity Cards
Dialogue: 0,0:02:23.60,0:02:25.47,Default,,0000,0000,0000,,is to determine the finest grating
Dialogue: 0,0:02:25.47,0:02:27.83,Default,,0000,0000,0000,,that the patient sees or detects.
Dialogue: 0,0:02:27.83,0:02:30.70,Default,,0000,0000,0000,,This gives the patient's\Nvisual acuity.
Dialogue: 0,0:02:30.70,0:02:31.83,Default,,0000,0000,0000,,
Dialogue: 0,0:02:31.83,0:02:34.03,Default,,0000,0000,0000,,This requires testing a series\Nof gratings,
Dialogue: 0,0:02:34.03,0:02:36.73,Default,,0000,0000,0000,,starting from relatively wide\Nand easily seen
Dialogue: 0,0:02:36.73,0:02:38.70,Default,,0000,0000,0000,,to progressively finer gratings,
Dialogue: 0,0:02:38.70,0:02:42.43,Default,,0000,0000,0000,,until the patient\Nno longer responds consistently.
Dialogue: 0,0:02:42.43,0:02:44.57,Default,,0000,0000,0000,,The recommended clinical method\Nof testing is
Dialogue: 0,0:02:44.57,0:02:46.93,Default,,0000,0000,0000,,for the examiner\Nto present a single grating
Dialogue: 0,0:02:46.93,0:02:49.73,Default,,0000,0000,0000,,a sufficient number of times\Nto judge whether the patient
Dialogue: 0,0:02:49.73,0:02:51.73,Default,,0000,0000,0000,,sees that grating.
Dialogue: 0,0:02:51.73,0:02:54.67,Default,,0000,0000,0000,,As there are only two locations\Nwhere the grating can appear,
Dialogue: 0,0:02:54.67,0:02:58.30,Default,,0000,0000,0000,,an examiner has a 50% chance\Nof guessing the correct location
Dialogue: 0,0:02:58.30,0:03:00.47,Default,,0000,0000,0000,,without even watching the patient.
Dialogue: 0,0:03:00.47,0:03:01.53,Default,,0000,0000,0000,,[no audible dialog]
Dialogue: 0,0:03:01.53,0:03:04.70,Default,,0000,0000,0000,,This means that gratings\Nmay need to be shown multiple times
Dialogue: 0,0:03:04.70,0:03:07.93,Default,,0000,0000,0000,,if the patient's responses\Nare not definitive.
Dialogue: 0,0:03:07.93,0:03:11.27,Default,,0000,0000,0000,,Typically, the patient's responses\Nwill be definitive
Dialogue: 0,0:03:11.27,0:03:14.90,Default,,0000,0000,0000,,when the grating is coarse\Nand above their acuity level.
Dialogue: 0,0:03:14.90,0:03:17.53,Default,,0000,0000,0000,,However, a finer grating\Nthat is more difficult
Dialogue: 0,0:03:17.53,0:03:20.73,Default,,0000,0000,0000,,for the patient to see\Nmay lead to more subtle responses
Dialogue: 0,0:03:20.73,0:03:22.83,Default,,0000,0000,0000,,and require more presentations.
Dialogue: 0,0:03:22.83,0:03:23.80,Default,,0000,0000,0000,,
Dialogue: 0,0:03:23.80,0:03:25.70,Default,,0000,0000,0000,,It is up to the examiner\Nto determine
Dialogue: 0,0:03:25.70,0:03:28.47,Default,,0000,0000,0000,,how many presentations\Nshe needs to be confident
Dialogue: 0,0:03:28.47,0:03:30.80,Default,,0000,0000,0000,,of the patient's visual acuity.
Dialogue: 0,0:03:30.80,0:03:33.07,Default,,0000,0000,0000,,[no audible dialog]
Dialogue: 0,0:03:33.07,0:03:34.60,Default,,0000,0000,0000,,
Dialogue: 0,0:03:34.60,0:03:38.03,Default,,0000,0000,0000,,There is a small hole in the center\Nof the Teller Acuity Card
Dialogue: 0,0:03:38.03,0:03:40.83,Default,,0000,0000,0000,,through which the examiner\Nor tester can view the patient
Dialogue: 0,0:03:40.83,0:03:44.17,Default,,0000,0000,0000,,as they look at the gray card\Nand the grating.
Dialogue: 0,0:03:44.17,0:03:46.60,Default,,0000,0000,0000,,The examiner can also view\Nthe patient's responses
Dialogue: 0,0:03:46.60,0:03:49.63,Default,,0000,0000,0000,,to the gratings\Nby looking over the top of the card.
Dialogue: 0,0:03:49.63,0:03:50.83,Default,,0000,0000,0000,,[no audible dialog]
Dialogue: 0,0:03:50.83,0:03:53.40,Default,,0000,0000,0000,,The examiner\Nis able to change the card position
Dialogue: 0,0:03:53.40,0:03:56.70,Default,,0000,0000,0000,,to judge where the grating\Nis located, right or left,
Dialogue: 0,0:03:56.70,0:03:58.87,Default,,0000,0000,0000,,based on the patient's\Nvisual behaviors,
Dialogue: 0,0:03:58.87,0:04:01.67,Default,,0000,0000,0000,,such as looking\Ntowards the right or left,
Dialogue: 0,0:04:01.67,0:04:04.90,Default,,0000,0000,0000,,or pointing or other behaviors.
Dialogue: 0,0:04:04.90,0:04:06.43,Default,,0000,0000,0000,,The card is shown to the patient
Dialogue: 0,0:04:06.43,0:04:09.13,Default,,0000,0000,0000,,by an examiner holding it\Nalong the edges.
Dialogue: 0,0:04:09.13,0:04:12.73,Default,,0000,0000,0000,,They should not be touching\Nthe front surface of the card.
Dialogue: 0,0:04:12.73,0:04:15.07,Default,,0000,0000,0000,,If the examiner uses fingers\Nto hold the card,
Dialogue: 0,0:04:15.07,0:04:16.100,Default,,0000,0000,0000,,rather than the palm of the hand,
Dialogue: 0,0:04:17.00,0:04:18.90,Default,,0000,0000,0000,,fingertips should not touch\Nthe front,
Dialogue: 0,0:04:18.90,0:04:22.17,Default,,0000,0000,0000,,except possibly within one inch\Nof the edge of the card.
Dialogue: 0,0:04:22.17,0:04:23.23,Default,,0000,0000,0000,,
Dialogue: 0,0:04:23.23,0:04:25.63,Default,,0000,0000,0000,,The examiner shows the card\Nin one position
Dialogue: 0,0:04:25.63,0:04:27.97,Default,,0000,0000,0000,,and makes a judgment as\Nto where the grating is
Dialogue: 0,0:04:27.97,0:04:30.20,Default,,0000,0000,0000,,based on the patient's behavior.
Dialogue: 0,0:04:30.20,0:04:33.90,Default,,0000,0000,0000,,In this case, the examiner\Njudges the grating to be on her left,
Dialogue: 0,0:04:33.90,0:04:35.50,Default,,0000,0000,0000,,the patient's right.
Dialogue: 0,0:04:35.50,0:04:36.33,Default,,0000,0000,0000,,
Dialogue: 0,0:04:36.33,0:04:40.63,Default,,0000,0000,0000,,The examiner\Nthen rotates the card 180 degrees.
Dialogue: 0,0:04:40.63,0:04:44.27,Default,,0000,0000,0000,,Now, if the infant's behavior\Nindicates seeing the grating,
Dialogue: 0,0:04:44.27,0:04:48.20,Default,,0000,0000,0000,,the examiner should judge\Nthe grating is on the infant's left.
Dialogue: 0,0:04:48.20,0:04:50.40,Default,,0000,0000,0000,,The examiner\Nshould not always rotate the card
Dialogue: 0,0:04:50.40,0:04:53.10,Default,,0000,0000,0000,,180 degrees between presentations,
Dialogue: 0,0:04:53.10,0:04:56.87,Default,,0000,0000,0000,,as some patients\Nmay anticipate the gratings position.
Dialogue: 0,0:04:56.87,0:04:59.90,Default,,0000,0000,0000,,Instead, the examiner\Nshould show the grating frequently
Dialogue: 0,0:04:59.90,0:05:02.10,Default,,0000,0000,0000,,in the same location.
Dialogue: 0,0:05:02.10,0:05:04.30,Default,,0000,0000,0000,,The examiner is being shown\Nholding the cards
Dialogue: 0,0:05:04.30,0:05:06.20,Default,,0000,0000,0000,,in a horizontal orientation,
Dialogue: 0,0:05:06.20,0:05:08.00,Default,,0000,0000,0000,,which is the standard\Nand most common way
Dialogue: 0,0:05:08.00,0:05:10.13,Default,,0000,0000,0000,,of presenting Teller Acuity Cards.
Dialogue: 0,0:05:10.13,0:05:13.63,Default,,0000,0000,0000,,However, the cards may be held\Nin a vertical orientation,
Dialogue: 0,0:05:13.63,0:05:17.13,Default,,0000,0000,0000,,with the grating either on the upper\Nor lower part of the card.
Dialogue: 0,0:05:17.13,0:05:19.37,Default,,0000,0000,0000,,This can be a useful method\Nfor testing patients
Dialogue: 0,0:05:19.37,0:05:22.100,Default,,0000,0000,0000,,with nystagmus or strabismus.
Dialogue: 0,0:05:23.00,0:05:24.50,Default,,0000,0000,0000,,
Dialogue: 0,0:05:24.50,0:05:27.20,Default,,0000,0000,0000,,During testing,\Npatients may wish to touch the grating
Dialogue: 0,0:05:27.20,0:05:30.87,Default,,0000,0000,0000,,or may invertently touch it\Nwhen trying to point to the grating.
Dialogue: 0,0:05:30.87,0:05:33.73,Default,,0000,0000,0000,,This should be avoided\Nby giving the child a soft toy to hold
Dialogue: 0,0:05:33.73,0:05:36.20,Default,,0000,0000,0000,,and point toward the grating.
Dialogue: 0,0:05:36.20,0:05:38.20,Default,,0000,0000,0000,,To keep the patient's attention,
Dialogue: 0,0:05:38.20,0:05:41.73,Default,,0000,0000,0000,,the examiner can interact with\Nand reinforce the patient
Dialogue: 0,0:05:41.73,0:05:44.07,Default,,0000,0000,0000,,for finding the grating location.
Dialogue: 0,0:05:44.07,0:05:45.37,Default,,0000,0000,0000,,[no audible dialog]
Dialogue: 0,0:05:45.37,0:05:46.83,Default,,0000,0000,0000,,
Dialogue: 0,0:05:46.83,0:05:49.87,Default,,0000,0000,0000,,Presenting a grating that has been\Nseen previously by the patient
Dialogue: 0,0:05:49.87,0:05:52.23,Default,,0000,0000,0000,,can reestablish interest\Nin the testing
Dialogue: 0,0:05:52.23,0:05:54.43,Default,,0000,0000,0000,,and also reassure the examiner\Nthat the infant
Dialogue: 0,0:05:54.43,0:05:56.43,Default,,0000,0000,0000,,is still attending\Nto the gratings.
Dialogue: 0,0:05:56.43,0:05:57.50,Default,,0000,0000,0000,,[no audible dialog]
Dialogue: 0,0:05:57.50,0:05:59.43,Default,,0000,0000,0000,,
Dialogue: 0,0:05:59.43,0:06:01.63,Default,,0000,0000,0000,,What behaviors\Ndoes the examiner use
Dialogue: 0,0:06:01.63,0:06:04.93,Default,,0000,0000,0000,,to judge whether the patient\Nsees a grating?
Dialogue: 0,0:06:04.93,0:06:06.67,Default,,0000,0000,0000,,The examiner must be aware of any
Dialogue: 0,0:06:06.67,0:06:08.80,Default,,0000,0000,0000,,and all patient cues and behaviors
Dialogue: 0,0:06:08.80,0:06:12.10,Default,,0000,0000,0000,,that indicate the location\Nof the grating.
Dialogue: 0,0:06:12.10,0:06:15.70,Default,,0000,0000,0000,,Typically, in young infants,\Na strong fixation response
Dialogue: 0,0:06:15.70,0:06:18.93,Default,,0000,0000,0000,,to one side of the card,\Npresumably at the grating,
Dialogue: 0,0:06:18.93,0:06:23.20,Default,,0000,0000,0000,,and then to the other side\Nwhen the card is rotated 180 degrees,
Dialogue: 0,0:06:23.20,0:06:26.43,Default,,0000,0000,0000,,indicates the infant detects\Nthat grating.
Dialogue: 0,0:06:26.43,0:06:29.20,Default,,0000,0000,0000,,Finer gratings may not be\Nas strongly fixated,
Dialogue: 0,0:06:29.20,0:06:33.63,Default,,0000,0000,0000,,yet will still elicit a consistent gaze\Nfrom the young infant.
Dialogue: 0,0:06:33.63,0:06:37.13,Default,,0000,0000,0000,,Older infants and toddlers\Nmay give brief glances to each side,
Dialogue: 0,0:06:37.13,0:06:38.83,Default,,0000,0000,0000,,which are accepted as detection,
Dialogue: 0,0:06:38.83,0:06:40.100,Default,,0000,0000,0000,,because the glance\Nis direct and clear,
Dialogue: 0,0:06:41.00,0:06:44.20,Default,,0000,0000,0000,,and repeated\Non subsequent presentations.
Dialogue: 0,0:06:44.20,0:06:46.50,Default,,0000,0000,0000,,Some mature toddlers\Nand young children
Dialogue: 0,0:06:46.50,0:06:48.10,Default,,0000,0000,0000,,may point to one side,
Dialogue: 0,0:06:48.10,0:06:50.77,Default,,0000,0000,0000,,especially if prompted by the examiner,\Nsuch as,
Dialogue: 0,0:06:50.77,0:06:52.73,Default,,0000,0000,0000,,"Where did the stripes go?"
Dialogue: 0,0:06:52.73,0:06:54.27,Default,,0000,0000,0000,,
Dialogue: 0,0:06:54.27,0:06:56.77,Default,,0000,0000,0000,,This section illustrates\Nthe complete sequence
Dialogue: 0,0:06:56.77,0:07:01.30,Default,,0000,0000,0000,,of testing a child's visual acuity\Nwith Teller Acuity Cards.
Dialogue: 0,0:07:01.30,0:07:04.63,Default,,0000,0000,0000,,Young patients are usually seated\Non their parent's lap,
Dialogue: 0,0:07:04.63,0:07:06.100,Default,,0000,0000,0000,,and the parent or holder\Nshould be cautioned
Dialogue: 0,0:07:07.00,0:07:10.07,Default,,0000,0000,0000,,not to give the child any guidance\Nduring testing.
Dialogue: 0,0:07:10.07,0:07:11.20,Default,,0000,0000,0000,,
Dialogue: 0,0:07:11.20,0:07:15.33,Default,,0000,0000,0000,,Based on the patient's age,\Ndetermine the start card for testing.
Dialogue: 0,0:07:15.33,0:07:18.93,Default,,0000,0000,0000,,Consult the Teller Acuity Card\NReference and Instruction Manual.
Dialogue: 0,0:07:18.93,0:07:19.100,Default,,0000,0000,0000,,
Dialogue: 0,0:07:20.00,0:07:22.17,Default,,0000,0000,0000,,If the patient\Nis visually impaired,
Dialogue: 0,0:07:22.17,0:07:24.50,Default,,0000,0000,0000,,a coarser grating than\Nthat based on age
Dialogue: 0,0:07:24.50,0:07:26.70,Default,,0000,0000,0000,,may be needed for the start card.
Dialogue: 0,0:07:26.70,0:07:28.00,Default,,0000,0000,0000,,
Dialogue: 0,0:07:28.00,0:07:30.07,Default,,0000,0000,0000,,Distance of the card\Nfrom the patient's face
Dialogue: 0,0:07:30.07,0:07:32.30,Default,,0000,0000,0000,,also depends upon age.
Dialogue: 0,0:07:32.30,0:07:36.37,Default,,0000,0000,0000,,Consult the Teller Acuity Card\NReference and Instruction Manual.
Dialogue: 0,0:07:36.37,0:07:41.27,Default,,0000,0000,0000,,
Dialogue: 0,0:07:41.27,0:07:43.20,Default,,0000,0000,0000,,The examiner\Nmeasures the test distance
Dialogue: 0,0:07:43.20,0:07:46.67,Default,,0000,0000,0000,,from the patient's eyes\Nto the position the card is held.
Dialogue: 0,0:07:46.67,0:07:49.70,Default,,0000,0000,0000,,For the 55-centimeter distance,\Nthe length of the card
Dialogue: 0,0:07:49.70,0:07:51.20,Default,,0000,0000,0000,,is an exact measure.
Dialogue: 0,0:07:51.20,0:07:52.37,Default,,0000,0000,0000,,
Dialogue: 0,0:07:52.37,0:07:55.73,Default,,0000,0000,0000,,For the 38-centimeter distance,\Nused with young infants
Dialogue: 0,0:07:55.73,0:07:57.100,Default,,0000,0000,0000,,and patients with limited vision,
Dialogue: 0,0:07:58.00,0:08:00.47,Default,,0000,0000,0000,,a measuring tape can be used.
Dialogue: 0,0:08:00.47,0:08:02.70,Default,,0000,0000,0000,,Or, a convenient measure\Nis the distance
Dialogue: 0,0:08:02.70,0:08:05.43,Default,,0000,0000,0000,,between the examiner's elbow\Nand fingers,
Dialogue: 0,0:08:05.43,0:08:07.50,Default,,0000,0000,0000,,with fingers either close or open,
Dialogue: 0,0:08:07.50,0:08:10.27,Default,,0000,0000,0000,,depending\Non the examiner's arm length.
Dialogue: 0,0:08:10.27,0:08:13.60,Default,,0000,0000,0000,,This needs to be measured\Nbefore testing.
Dialogue: 0,0:08:13.60,0:08:15.53,Default,,0000,0000,0000,,For 84-centimeter distance,
Dialogue: 0,0:08:15.53,0:08:18.100,Default,,0000,0000,0000,,used with older children,\Na measuring tape is needed.
Dialogue: 0,0:08:19.00,0:08:21.40,Default,,0000,0000,0000,,Alternatively,\Na measuring tape can be placed
Dialogue: 0,0:08:21.40,0:08:24.80,Default,,0000,0000,0000,,on a table surface, adjacent\Nto the patient and the examiner,
Dialogue: 0,0:08:24.80,0:08:27.60,Default,,0000,0000,0000,,with marks for each distance.
Dialogue: 0,0:08:27.60,0:08:29.97,Default,,0000,0000,0000,,The examiner should check\Nthe test distance periodically
Dialogue: 0,0:08:29.97,0:08:32.63,Default,,0000,0000,0000,,during the testing,\Nas some patients will lean forward
Dialogue: 0,0:08:32.63,0:08:34.50,Default,,0000,0000,0000,,to get closer to the gratings,
Dialogue: 0,0:08:34.50,0:08:37.80,Default,,0000,0000,0000,,especially when they\Nbecome finer and more difficult to see.
Dialogue: 0,0:08:37.80,0:08:39.10,Default,,0000,0000,0000,,
Dialogue: 0,0:08:39.10,0:08:42.20,Default,,0000,0000,0000,,Set up the cards in two stacks\Nwith the grading face down
Dialogue: 0,0:08:42.20,0:08:44.93,Default,,0000,0000,0000,,on a soft, clean surface.
Dialogue: 0,0:08:44.93,0:08:47.23,Default,,0000,0000,0000,,The card labels are up.
Dialogue: 0,0:08:47.23,0:08:49.83,Default,,0000,0000,0000,,One stack is for gratings\Nthe patient has not seen,
Dialogue: 0,0:08:49.83,0:08:51.83,Default,,0000,0000,0000,,or will not be tested on,
Dialogue: 0,0:08:51.83,0:08:54.70,Default,,0000,0000,0000,,and the other stack is\Nfor cards the patient has seen
Dialogue: 0,0:08:54.70,0:08:57.60,Default,,0000,0000,0000,,or are larger\Nthan need to be presented.
Dialogue: 0,0:08:57.60,0:08:59.70,Default,,0000,0000,0000,,Stacking the cards\Nwith the grating face down
Dialogue: 0,0:08:59.70,0:09:01.73,Default,,0000,0000,0000,,keeps the examiner unaware\Nof the position
Dialogue: 0,0:09:01.73,0:09:03.87,Default,,0000,0000,0000,,of the grading before testing.
Dialogue: 0,0:09:03.87,0:09:07.63,Default,,0000,0000,0000,,It also minimizes damage\Nto the grating face of the card.
Dialogue: 0,0:09:07.63,0:09:09.63,Default,,0000,0000,0000,,Papers can be inserted\Nbetween each card
Dialogue: 0,0:09:09.63,0:09:12.67,Default,,0000,0000,0000,,in order to minimize marks\Nor blemishes.
Dialogue: 0,0:09:12.67,0:09:15.83,Default,,0000,0000,0000,,The not-seen stack\Nhas the start card top-most,
Dialogue: 0,0:09:15.83,0:09:17.43,Default,,0000,0000,0000,,with progressively fine gratings
Dialogue: 0,0:09:17.43,0:09:19.73,Default,,0000,0000,0000,,in series below the top card.
Dialogue: 0,0:09:19.73,0:09:22.50,Default,,0000,0000,0000,,
Dialogue: 0,0:09:22.50,0:09:24.87,Default,,0000,0000,0000,,The seen stack\Nhas the gratings that are coarser
Dialogue: 0,0:09:24.87,0:09:25.100,Default,,0000,0000,0000,,than the start card,
Dialogue: 0,0:09:26.00,0:09:29.60,Default,,0000,0000,0000,,in a series of progressively\Nwider stripes below the top card.
Dialogue: 0,0:09:29.60,0:09:31.43,Default,,0000,0000,0000,,
Dialogue: 0,0:09:31.43,0:09:35.13,Default,,0000,0000,0000,,The examiner picks up the top card\Nfrom the not-seen stack,
Dialogue: 0,0:09:35.13,0:09:37.87,Default,,0000,0000,0000,,and tests the infant\Nwith this grating.
Dialogue: 0,0:09:37.87,0:09:40.23,Default,,0000,0000,0000,,If she judges the infant\Ndetects the grating,
Dialogue: 0,0:09:40.23,0:09:42.70,Default,,0000,0000,0000,,she places it on the seen stack.
Dialogue: 0,0:09:42.70,0:09:46.00,Default,,0000,0000,0000,,
Dialogue: 0,0:09:46.00,0:09:49.23,Default,,0000,0000,0000,,At some point, the series\Nof judgments will become difficult,
Dialogue: 0,0:09:49.23,0:09:50.57,Default,,0000,0000,0000,,and the examiner may be unsure
Dialogue: 0,0:09:50.57,0:09:52.87,Default,,0000,0000,0000,,whether the patient detects\Nthat grating.
Dialogue: 0,0:09:52.87,0:09:54.90,Default,,0000,0000,0000,,The examiner does not look\Nat the front of the card
Dialogue: 0,0:09:54.90,0:09:57.27,Default,,0000,0000,0000,,for this grating location.
Dialogue: 0,0:09:57.27,0:10:00.57,Default,,0000,0000,0000,,The examiner places the card\Nthe infant does not detect
Dialogue: 0,0:10:00.57,0:10:03.17,Default,,0000,0000,0000,,on top of the not-seen stack.
Dialogue: 0,0:10:03.17,0:10:05.40,Default,,0000,0000,0000,,
Dialogue: 0,0:10:05.40,0:10:08.73,Default,,0000,0000,0000,,The examiner then retests\Nthe previously seen grating.
Dialogue: 0,0:10:08.73,0:10:11.03,Default,,0000,0000,0000,,And if she judges the infant\Ndetects it,
Dialogue: 0,0:10:11.03,0:10:14.33,Default,,0000,0000,0000,,she places the card on top\Nof the seen stack again.
Dialogue: 0,0:10:14.33,0:10:15.37,Default,,0000,0000,0000,,[no audible dialog]
Dialogue: 0,0:10:15.37,0:10:18.30,Default,,0000,0000,0000,,
Dialogue: 0,0:10:18.30,0:10:20.47,Default,,0000,0000,0000,,If the examiner still cannot determine\Nthat the patient
Dialogue: 0,0:10:20.47,0:10:21.67,Default,,0000,0000,0000,,detects the grating,
Dialogue: 0,0:10:21.67,0:10:24.73,Default,,0000,0000,0000,,this indicates that a below-threshold\Ngrating has been found,
Dialogue: 0,0:10:24.73,0:10:26.63,Default,,0000,0000,0000,,and testing is completed.
Dialogue: 0,0:10:26.63,0:10:28.03,Default,,0000,0000,0000,,The next-coarser grating,
Dialogue: 0,0:10:28.03,0:10:30.83,Default,,0000,0000,0000,,the finest the patient\Nresponds positively to,
Dialogue: 0,0:10:30.83,0:10:33.83,Default,,0000,0000,0000,,is recorded\Nas the patient's acuity.
Dialogue: 0,0:10:33.83,0:10:36.67,Default,,0000,0000,0000,,Sometimes, retesting results\Nin different decisions
Dialogue: 0,0:10:36.67,0:10:38.10,Default,,0000,0000,0000,,on the patient's detection,
Dialogue: 0,0:10:38.10,0:10:40.97,Default,,0000,0000,0000,,and the examiner must go back\Nand forth between several cards
Dialogue: 0,0:10:40.97,0:10:43.17,Default,,0000,0000,0000,,to determine the patient's acuity.
Dialogue: 0,0:10:43.17,0:10:44.57,Default,,0000,0000,0000,,
Dialogue: 0,0:10:44.57,0:10:45.97,Default,,0000,0000,0000,,After testing a patient,
Dialogue: 0,0:10:45.97,0:10:49.10,Default,,0000,0000,0000,,the cards can be placed\Nin a single stack, ready for storage.
Dialogue: 0,0:10:49.10,0:10:50.13,Default,,0000,0000,0000,,
Dialogue: 0,0:10:50.13,0:10:52.83,Default,,0000,0000,0000,,We recommend randomly\Nreordering the right-left locations
Dialogue: 0,0:10:52.83,0:10:55.63,Default,,0000,0000,0000,,of the gratings to avoid\Nbiasing the grating locations
Dialogue: 0,0:10:55.63,0:10:57.47,Default,,0000,0000,0000,,to one side.
Dialogue: 0,0:10:57.47,0:11:00.67,Default,,0000,0000,0000,,As indicated,\Nthe finest or smallest grating size
Dialogue: 0,0:11:00.67,0:11:03.33,Default,,0000,0000,0000,,that the patient is judged to see\Nby the examiner
Dialogue: 0,0:11:03.33,0:11:05.100,Default,,0000,0000,0000,,defines their visual acuity.
Dialogue: 0,0:11:06.00,0:11:08.17,Default,,0000,0000,0000,,The recording form shown\Nin the handbook
Dialogue: 0,0:11:08.17,0:11:10.77,Default,,0000,0000,0000,,can be used to record information\Nabout the patient,
Dialogue: 0,0:11:10.77,0:11:12.40,Default,,0000,0000,0000,,such as name,
Dialogue: 0,0:11:12.40,0:11:14.00,Default,,0000,0000,0000,,date of birth,
Dialogue: 0,0:11:14.00,0:11:15.33,Default,,0000,0000,0000,,test date,
Dialogue: 0,0:11:15.33,0:11:16.100,Default,,0000,0000,0000,,and age.
Dialogue: 0,0:11:17.00,0:11:19.13,Default,,0000,0000,0000,,It is also used\Nto record the important results
Dialogue: 0,0:11:19.13,0:11:20.73,Default,,0000,0000,0000,,of the acuity test,
Dialogue: 0,0:11:20.73,0:11:24.40,Default,,0000,0000,0000,,including the acuity card\Nat threshold in cycles per centimeter,
Dialogue: 0,0:11:24.40,0:11:27.37,Default,,0000,0000,0000,,test distance, and acuity conversion.
Dialogue: 0,0:11:27.37,0:11:29.17,Default,,0000,0000,0000,,The examiner can take the value
Dialogue: 0,0:11:29.17,0:11:32.53,Default,,0000,0000,0000,,from the "Teller Acuity Card Handbook,\NAppendix D,"
Dialogue: 0,0:11:32.53,0:11:35.20,Default,,0000,0000,0000,,showing conversions\Nfrom cycles per centimeter
Dialogue: 0,0:11:35.20,0:11:38.93,Default,,0000,0000,0000,,to cycles per degree, Table 1,
Dialogue: 0,0:11:38.93,0:11:42.33,Default,,0000,0000,0000,,and from cycles per centimeter\Nto Snellen equivalents.
Dialogue: 0,0:11:42.33,0:11:46.33,Default,,0000,0000,0000,,
Dialogue: 0,0:11:46.33,0:11:49.23,Default,,0000,0000,0000,,The patient's acuity can be shown\Non an age-norm graph
Dialogue: 0,0:11:49.23,0:11:51.87,Default,,0000,0000,0000,,from the "Teller Acuity Card\NHandbook."
Dialogue: 0,0:11:51.87,0:11:54.87,Default,,0000,0000,0000,,The patient's age is noted\Nat the bottom of the graph.
Dialogue: 0,0:11:54.87,0:11:56.73,Default,,0000,0000,0000,,The test distance is circled,
Dialogue: 0,0:11:56.73,0:11:58.37,Default,,0000,0000,0000,,and the grating\Nin cycles per centimeter
Dialogue: 0,0:11:58.37,0:12:02.03,Default,,0000,0000,0000,,in the column\Nunder the test distance is also circled.
Dialogue: 0,0:12:02.03,0:12:05.70,Default,,0000,0000,0000,,A line is drawn from this value\Nacross to the patient's age.
Dialogue: 0,0:12:05.70,0:12:07.27,Default,,0000,0000,0000,,This shows\Nwhere the patient's acuity
Dialogue: 0,0:12:07.27,0:12:10.80,Default,,0000,0000,0000,,falls relative to the normal range\Nfor that age.
Dialogue: 0,0:12:10.80,0:12:12.30,Default,,0000,0000,0000,,All values are then recorded
Dialogue: 0,0:12:12.30,0:12:15.00,Default,,0000,0000,0000,,in the results section\Nof the recording form.