Introduction

Brightness acuity testing is a simple test that allows you to determine the amount of scatter induced by cataract changes within the natural lens.

Indications

Patient with suspected or confirmed cataract.

Patient with suspected or confirmed posterior capsular opacification (secondary cataract).

Suspect cataracts or secondary cataracts if the patient reports reduced visual acuities that can’t be explained refractively or complaints of glare and/or halos with night driving.

The patient chart will confirm a prior diagnosis of a primary or secondary cataract in the assessment and plan.

Contra-Indications

Known decreased visual acuities secondary to other pathologies

Materials

1. Brightness Acuity Tester (BAT)
2. Distance visual acuity chart

Setup

1. With the patient wearing their BCVA correction, display the patient’s best corrected visual acuity as the lowest line on the distance chart.
2. Occlude one eye
3. Turn the BAT to either LO, MED, or HI, and place in front of the patient’s un-occluded eye.
4. Have the patient read the acuity chart, recording their best acuity as well as the BAT setting (LO, MED, or HI).
5. Repeat with the other eye

Results

Record the name of the test (BAT), the eye tested, the BAT setting (LO, MED, HI), and the BAT visual acuity.

Cataract surgery is indicated if visual acuities with or without BAT are 20/50 or worse, and can be attributed to cataracts (via slit lamp examination).  Note that currently coverage appears to be loosened to include quality of life issues, such as inability to perform tasks of daily living.

References

None