AMSLER CHART

FIT CLINIC-WK15

Do you see the white spot in the centre of the squared

chart?
YES- There is no central scotoma and we can pass to next qs
YES BUT BLURRED- There is relative central scotoma, limits of
which a Px can point out in a circle around central spot.
NO central spot, only SEEN WHEN GLANCE TO SIDE- An
absolute central scotoma. Show Px chat no.2 on which
diagonal lines help fix centre of square & Px can then point
out limits of scotoma. Can be traced more accurately by
apparatus of Haitz
Note: Px must keep gaze fixed on central pt during examination with
every chart.
Keep gaze fixed upon the white spot in centre. Can you see
the four corners of the big square? Can you also see the four
sides of the square? In other words can you see the whole of
the square?
YES- Move to 3rd question.
NO, ONE CORNER(S)/ SIDE CUT OFF- Exterior scotoma as
outside areas invaded. Arcuate scotoma of Bjerrum found in
chronic glaucoma, which coming from the neighbouring blind
spot, covers in its curved course the superior/ inferior
temporal angle of a square, or both at once. Or px may point
loss of the other side of square, this is nasal restriction, also
characteristic of chronic glaucoma + accentuates atleast 10
degrees degeneration of retina. The all round loss of focus
point (annular scotoma) will be shown by the disappearance of
corners & sides of the square.
Caecocentral scotoma of toxic amblyopia , which is bilateral
and temporal to the blind spot. Often partially absoulute
(nucleus) and partially relative. Use chart 3 in this case.
While always keeping gaze fixed on central fixation pt., do
you see the network intact in the whole square? Or are there
interruptions in the network of squares, like holes or spots?
Is it blurred in any place? And if so, where?
Deals with juxt- and paracentral scotoma, absolute or relative,
of which the px can point out location. Is the spot completely
blurred (relative scotoma) or do white lines show through
(relative scotoma). Chart 4 gives perception of scotoma
Always keeping the gaze fixed on the white spot in the
entre, do you see all the lines, both horizontal & vertical,
straight and parallel? In other words is every square equal
size + perfectly regular?
Exploring symptom of the many types of metamorphopsia. All
the varieties of distortions are often continuous among

AMSLER CHART

FIT CLINIC-WK15

themselves and with the scotoma. Clearly show the

potentialities of this functional examination. Charts 5/6 helpful
for diff types of metamorphopsia. Hold them horizontally, then
vertically and obliquely if needed.
Always fixing the gaze upon the centre point, independently
of blurred spots and distortions, can you see anything else?
Movement of certain lines? Vibration or wavering? Shining?
Colour tint? If so, where?
Many affirmative replies with fresh maculopathies. Entopic
perceptions.
Wavering can be precursor of scotoma and can reappear when
scotoma has disappeared.
Can analyse, localize and see many symptions revealing
smallest of disturbances which can be missed.
Keeping central point fixed, at what distance from this point
do you place the blur or distortion you see? How many small
intact squares do you find between the blur on distortion
and the central point that you are keeping your gaze upon?
Great clinical significance.
Usually reply with ease as we ask about something in the
central area where eccentric va is still sufficient to allow an
accurate estimation. The reply of the Px tells threat to foveola.
Functional changes far more than opthalmoscopic ones.
Juxta-central visual disturbances more accurately. Use chart 7
(central rectangle subdivided into smaller squares contains
the fovea). Also good in use of high myopia, when held in the
punctum remotum of the uncorrected eye.