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A well-illuminated visual acuity chart set at 20 ft is used to test distance vision; a reading card with various print sizes is used to test near vision. (The chart is placed at 10 ft if a mirror is used.) Patients who cannot read the 20/40 line on the chart even while wearing distance eyeglasses should look through a pinhole (the opening made by a pin pushed through a piece of thin cardboard). If the patient needs glasses or a new prescription, acuity should improve to at least 20/30 when the pinhole is used. If acuity does not improve, the patient has a nonrefrac-tive problem and should be referred to an ophthalmologist immediately.
Near vision can also be tested by asking the patient to read ordinary newsprint. If the patient cannot, yet has good distance vision, only a change in reading glasses is indicated.

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