A nurse is planning to test the visual acuity of a 7-year-old. Which is the best way to test visual acuity in this child?

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11ecbb05_caf5_3286_b433_996da3ecca68_MD0009_00 Visual acuity testing in children ages 6 and older is generally assessed by use of the Snellen letter chart. The child is positioned 10 ft (3 m) from the chart and asked to read the letters, beginning with the lines of large text to small text. Standard testing for visual acuity is at 20 ft (6 m); however, the American Academy of Pediatrics recommends testing at 10 ft as it is easier to maintain the child's attention and provides a more accurate result. If the child wears glasses, they remain in place. Both eyes should remain open while one eye at a time is covered to read the chart. The child must identify 4 of 6 letters in each line before moving to the next. A referral to an ophthalmologist is made if a child is unable to identify 4 correct letters on the 10/15 line (equivalent to 20/30 vision) with either eye. (Option A) Following a target, usually a bright-colored object or a human face, is a method of testing visual acuity and fixation in infants. If visual fixation and following are not present by age 3-4 months, referral to a formal ophthalmic examination is needed. (Option B) Viewing a set of cards one at a time is a test of color vision deficits, not visual acuity. (Option D) The corneal light reflex is tested by shining a light held 16 in (40.6 cm) from the child's eyes. Although this is not the best option, it can be used to test vision in newborns. The nurse observes blink response, alertness, and following the light to the middle. Educational objective: Distance visual acuity of children age 6 or older is best assessed by asking the child to read letters from the Snellen letter chart using one eye at a time. The child should be able to identify 4 out of 6 letters on the 10/15 line (equivalent to 20/30 vision) with both eyes. In infancy, visual fixation should be present by age 3-4 months and is assessed by following a target.

A Nurse Is Planning to Test the Visual Acuity of a 7-Year-Old