The AMSLER Grid Eye Test is a useful tool for those at home that worry about the health of their eyesight. The free template document allows you to quickly assess if there is degeneration of the eye, more commonly referred to as a damaged macula by eye specialists. This simple, yet convenient template can help you gauge if there are any problems with your eyes simply by looking at a dot. If you’re interested in downloading and using this free template, and then follow the link at the bottom of your screen to get started.
How to Use the AMSLER Grid Eye Test Template
To download this free AMSLER Grid Eye Test to your computer, just follow the link at the bottom of this page.
Next, fill out the information or the information of your patient at the very top of the AMSLER Grid Eye Test. You will enter the name, reference record, phone number, date of birth and gender.
Below you will see a list of directions, along with a simple graph with a dot at the center. Next, follow the steps laid out before you in the text above. Note, if you use glasses or contacts, put them on for this test.
Now, cover one of your eyes then look at the dot at the center of the graph.
Try to notice if any of the lines look “wavy” or if you see blurred/distorted lines in any way. All the lines of the graph should be straight and clear to see. You will then try the same thing with the other eye.
A few other things to keep notice of are missing areas or dark areas and if all the corners and sides of the grid are seen.
If you experience any of the irregularities listed, you should inform your doctor about the test and your issues to get you treated right away.
Download: amsler-grid-eye-test
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