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Charts usually display several rows of optotypes (test symbols), each row in a different size. The person is asked to identify the numbers or letters on the chart, usually starting with large rows and continuing to smaller rows until the optotypes cannot be reliably identified anymore.
Charts are available for very young children or illiterate adults that do not require letter recognition. One version uses simple pictures or patterns. Others are printed with the block letter "E" turned in different orientations, the so called Tumbling E. The patient simply indicates which direction each "E" is facing. The Landolt C chart is similar: rows have circles with different segments missing, and the test-taker describes where each broken piece is located. The last two kinds of charts also reduce the possibility of the patient guessing the images.
Computer-based semi-automatic alternatives to the eye chart have been developed, but are not very common. They have several potential advantages, such as a more precise measurement and less examiner-induced bias. Some of them are also well suited for children since they resemble a video game.
While visual acuity charts are usually designed for use at 6 metres or 20 feet, there is often also a need to test a subject's vision at near or occupational tasks (like reading or computer use). For these situations near-point charts have been created.
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