Low vision assessment form 2025

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A person with low vision may not recognize images at a distance or be able to differentiate between colors of similar hues. Those who are legally blind may only see light and dark images and may need to be inches away from objects to observe them properly.
The World Health Organization defines low vision as visual acuity between 20/70 and 20/400, with the best possible correction, or a visual field of 20 degrees or less. Blindness is defined as a visual acuity worse than 20/400, with the best possible correction, or a visual field of 10 degrees or less.
They will use eye charts and reading materials similar to the charts used in standard eye tests, but in a different way. The Optometrist will test other aspects of your vision using different tools, including: The Snellen or LogMAR charts to test distance. Near Vision test using differing font sizes.
The functional vision assessment (FVA) is for children with low vision. It is an assessment of how a child uses their vision in everyday life, so it is usually not done with children who are totally blind or have light perception only.
You have a VISUAL DISABILITY if your: vision is 20/70 (by Snellen Chart or equivalent) or worse in the better eye. field of vision is less than 20 degrees wide (by automated perimeter) in the better eye. vision cannot be improved by eyeglasses, medication, or surgery.
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Unlike regular comprehensive exams, low vision exams may not revolve around treatment of the eye disease; instead, they explore different devices and adaptive techniques to allow the patient to use the vision they have in order to achieve specific goals.
We consider you to be blind if your vision cant be corrected to better than 20/200 in your better eye. We also consider you blind if your visual field is 20 degrees or less in your better eye for a period that lasted or is expected to last at least 12 months. The duration requirement does not apply for SSI payments.

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