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A Swiss ophthalmologist named Marc Amsler first developed the grid in 1947 and is currently used to detect or continue monitoring for scotoma (blind spot) or metamorphopsia (vision distortion).
Uses and Varieties of Visual Field Tests
Visual field tests are a method an eye doctor (opthalmologist or optometrist) can use to measure how wide an area you can visualize away from a focal point. This is a common test to evaluate for scotomas and also evaluate any visual field restrictions from eyelid disorders likeptosis(droopy upper eyelid). Types of visual field tests include:
The Amsler grid is different from the other visual field tests because it can be tested at home on paper. The other visual field tests must be administered in an eye doctor’s office.
What Can the Amsler Grid Help Diagnose?
The Amsler grid can help screen for the following conditions that cause a scotoma:
The Amsler grid can also help screen for causes of metamorphopsia related to both AMD as well asepiretinal membrane.
What Are the Early Warning Signs of Macular Degeneration?
Types and Versions of Amsler Grids
There are seven different versions of the Amsler grid that are available for use in order to identify or further delineate metamorphopsia and scotoma.
White or Black Backgrounds for Amsler Grid
If you search for Amsler grids online, you will typically see examples of Grid 1 except with a white background and black lines and a black central dot. Is this OK to use?
Amsler originally created this test on a black background with white lines and a white central dot. The Amsler grid on a white background is a modified version. The white background with black lines is more commonly seen, however it is unclear if they are equal in efficacy.
How the Amsler Grid Exam Is Performed at Home
Before starting this self-examination process at home, it is ideal to discuss with your eye doctor and have the first exam performed in the office to ensure proper training. Before initiating this exam, it is important to have avoided any bright lights to your eye; exposure causes photostress that could cause visual distortions that are not related to any disorder. To perform the self-administered Amsler grid test follow the following directions at least weekly.
To prepare for your home Amsler grid exam:
Identify these characteristics:
Distorted or warped lines represent metamorphopsia, while lines that disappear represent blind spots (scotomas). Keep the marked Amsler grid for later reference, as changes in the area of distortion can represent a progressive condition, stabilized condition, or improvement in your condition.
If you notice distortion for the first time, you will need to have a professional eye exam. While performing the Amsler grid test, if you are unable to see all four corners of the grid you should also have an eye exam to check for conditions such asglaucomaorretinitis pigmentosa.
Contraindications to Using the Amsler Grid Exam
There is not any known reason that would restrict you from using the Amsler Grid to test your vision. While there isn’t a reason that would restrict the use of this test for checking for blind spots, the Amsler test is not used in determining the physiologic blind spot and is not useful in detecting early-stage visual field defects related to glaucoma.
If you are having your eyes dilated with mydriatic drops at your eye doctor’s office, the Amsler grid test should be performed prior to the administration of the eye drops. If the eye drops have already been administered, you would need to reschedule the exam at a later date.
Disadvantages of the Amsler Grid Exam
While the Amsler grid is simple to use at home and monitor for the development or changes in macular degeneration, there are a few disadvantages to using the Amsler grid.
Alternative Eye Exams to the Amsler Grid
There are several alternatives that may be available for you to use if you do not want to use the Amsler grid to track any development or changes to blind spots or visual distortions.
2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Schuchard RA.Validity and Interpretation of Amsler Grid Reports.Arch Ophthalmol.1993;111(6):776–780. doi:10.1001/archopht.1993.01090060064024Goldstein M, Loewenstein A, Barak A, et al. Results of a multicenter clinical trial to evaluate the preferential hyperacuity perimeter for detection of age-related macular degeneration. Retina. 2005 Apr-May;25(3):296-303.Additional ReadingTripathy K, Salini B. Amsler Grid. [Updated 2019 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan.https://www.ncbi.nlm.nih.gov/books/NBK538141/Visual Field Test. American Academy of Opthalmology.https://www.aao.org/eye-health/tips-prevention/visual-field-testing. Updated January 27, 2019.
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Schuchard RA.Validity and Interpretation of Amsler Grid Reports.Arch Ophthalmol.1993;111(6):776–780. doi:10.1001/archopht.1993.01090060064024Goldstein M, Loewenstein A, Barak A, et al. Results of a multicenter clinical trial to evaluate the preferential hyperacuity perimeter for detection of age-related macular degeneration. Retina. 2005 Apr-May;25(3):296-303.Additional ReadingTripathy K, Salini B. Amsler Grid. [Updated 2019 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan.https://www.ncbi.nlm.nih.gov/books/NBK538141/Visual Field Test. American Academy of Opthalmology.https://www.aao.org/eye-health/tips-prevention/visual-field-testing. Updated January 27, 2019.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Schuchard RA.Validity and Interpretation of Amsler Grid Reports.Arch Ophthalmol.1993;111(6):776–780. doi:10.1001/archopht.1993.01090060064024Goldstein M, Loewenstein A, Barak A, et al. Results of a multicenter clinical trial to evaluate the preferential hyperacuity perimeter for detection of age-related macular degeneration. Retina. 2005 Apr-May;25(3):296-303.
Schuchard RA.Validity and Interpretation of Amsler Grid Reports.Arch Ophthalmol.1993;111(6):776–780. doi:10.1001/archopht.1993.01090060064024
Goldstein M, Loewenstein A, Barak A, et al. Results of a multicenter clinical trial to evaluate the preferential hyperacuity perimeter for detection of age-related macular degeneration. Retina. 2005 Apr-May;25(3):296-303.
Tripathy K, Salini B. Amsler Grid. [Updated 2019 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan.https://www.ncbi.nlm.nih.gov/books/NBK538141/Visual Field Test. American Academy of Opthalmology.https://www.aao.org/eye-health/tips-prevention/visual-field-testing. Updated January 27, 2019.
Tripathy K, Salini B. Amsler Grid. [Updated 2019 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan.https://www.ncbi.nlm.nih.gov/books/NBK538141/
Visual Field Test. American Academy of Opthalmology.https://www.aao.org/eye-health/tips-prevention/visual-field-testing. Updated January 27, 2019.
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