On reflection...

Measuring change - establishing what is normal for your patient and when you should take action. Also, how regular reflection can lead to positive change and a look at the role for the Snellen chart in modern practice.

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Published: Spring 2016


How do you measure change? When is change significant? These are questions that we need to answer routinely when examining patients. The art, in medicine, is in detecting change. If something doesn’t change then it is – almost certainly – normal for that patient, which is why it is more difficult to ascertain what is normal when you see a new patient. To this end I have just read Lovie-Kitchin’s update on her 1988 Ophthalmic and Physiological Optics paper on visual acuity measurement. 

With the plethora of computerised test charts now in use (and I wouldn’t be without mine), how many of us still use the Snellen type charts?

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