Amsler's Charts: by Disha Mamniya

Amsler’s Charts
By Disha Mamniya
What are Amsler’s Charts?
Amsler’s Chart comprises of Seven Charts, each with a
slightly different pattern and purpose.
All charts are in shape of squares, covering an area of
100cms2 (10cms x 10cms).
When they are held at 30cms (12 inches) from the eye, they allow
assessment of the central 20 Deg.
Of the visual field, correlating with the area inside the temporal vascular
Chart 1
◦ The most familiar and widely used is the Standard Black and
White Amsler’s Grid.
◦ This is merely a grid pattern consisting of 0.5cms White or Black
squares, each corresponding to 1 Deg. of Visual field area that is
set against a Black or a White background, respectively.
◦ They are arranged in 20 horizontal (or vertical) rows of 20 squares
each.
◦ This Grid helps clinician to identify various forms of distortion as
well as Relative and Absolute scotomas.
Chart 2
◦ This Chart is similar to Chart 1 with the only difference being the Diagonal lines that intersect at the
center of the grid to form a “ X ”.

◦ A patient with central visual loss may respond well to this chart as compared to chart 1 as this
charts gives the patient, a better idea of where the fixation point is located.
◦ A larger white central spot may be applied with a tape to the center of the grid if the patient is
unable to achieve or maintain central fixation.
Chart 3
◦ This Chart is similar to Chart 1 with the only
difference being the chart consisting of Red
squares instead of White ones on a Black
background.
◦ The Patients who are suspected of
Malingering (pretending to have a visual
problem), having Central or Paracentral
visual field loss due to Amblyopia, Alcohol
related Vitamin B 1 deficiency, Maculopathy
due to over intake of Quinine should be
tested with this chart.
◦ It is used along with Red and Green glasses.
Chart 4
◦ This Chart has NO LINES to distort, instead,
it is filled with Small White Dots randomly
distributed over a black background like
stars in the sky.
◦ The Patient with one or more areas of
Paracentral visual field loss may be able to
Recognize and Record the boundaries of
areas of field loss(areas of involvement),
more specifically and easily with this chart.
Chart 5
◦ This Chart consists of 20 evenly spaced White
Horizontal lines on Black Background.
◦ This chart can be rotated in any other meridian, at
any particular axis to check for irregularities in a
particular area suspected of having a visual field
loss.
◦ A patient experiencing Central or Paracentral
distortions in the visual field commonly referred
to as Metamorphopsia, may be especially
sensitive to this type of an Amsler’s Chart.
Chart 6
◦ This Chart 6 varies slightly from Chart 5 as
it contains Black lines against a white
Background.
◦ The areas 1 Deg. Above and Below the
Central Fixation Dot, are bisected by
additional Horizontal lines.
◦ Metamorphopsia (distortions in the visual
field) along the reading level may more
easily observed, with this chart.
Chart 7
◦ This chart is similar to chart 1 with the difference being the white
lines on black background and visa versa, that divide the
horizontally oriented 6 Deg x 8 Deg central area of the chart (this
area corresponds to the macular region) into 0.5 Deg, squares
further as compared to 1Deg. Squares present in the rest of the
chart.
◦ This division of this central area, makes the chart more sensitive
detector of any finer or smaller macular compromises that might
cause a visual field distortion.
◦ Subtle disturbances from the macular region of the retina can be
detected using this chart.

Modified Amsler’s Charts
1. Yannuzzi’s Card :
Being a minified version of the Amsler’s chart, it is
composed of 16 x 10, 0.5cms squares that corresponds to
16 Deg. X 10 Deg. Of visual angle area when held at a
distance of 30cms from the eye.
This card can be held horizontally or vertically to cover a
larger overall area of the visual field.
This card is of the size of a credit card and is popular for its
convenience, portability and relatively high sensitivity to
visual disturbance corresponding to that in the macular
region.
Diamond Chart
◦ This Chart is similar to Amsler’s chart 5 and 6, containing
evenly spaced bold horizontal black lines on white
background.
◦ This chart contains a central red 0.5cms fixation dot and a
red diamond situated 10cms to one side of the dot.
◦ The red dot is intended to hold the attention of the patient
and the red diamond is used to ensure central fixation and Diamond Chart
monocular viewing at 40cms distance from the eye.
◦ The chart can be rotated 180 Deg. From its original position
to test the fellow eye when one is done testing with this
chart.
◦ This chart was developed to obtain more consistent and
reliable responses in patients with Age related Macular
degeneration.
Clinical Use and importance
◦ The Amsler’s charts have attained an important benchmark in contemporary clinical practice because of
their ease of administration and accessibility.
◦ They have greatly enhanced the clinician's ability to evaluate the extent of functional damage caused by
various diseases involving the parts of the eye such as the Retina, choroid, optic nerve, orbit, anterior
visual system, visual pathways and cortex.

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Amsler’s Charts

assessment of the central 20 Deg.

center of the grid to form a “ X ”.

lines on black background and visa versa, that divide the

horizontally oriented 6 Deg x 8 Deg central area of the chart (this

area corresponds to the macular region) into 0.5 Deg, squares

further as compared to 1Deg. Squares present in the rest of the

detector of any finer or smaller macular compromises that might

cause a visual field distortion.

◦ Subtle disturbances from the macular region of the retina can be

detected using this chart.

Being a minified version of the Amsler’s chart, it is

composed of 16 x 10, 0.5cms squares that corresponds to

16 Deg. X 10 Deg. Of visual angle area when held at a

distance of 30cms from the eye.

This card can be held horizontally or vertically to cover a

larger overall area of the visual field.

convenience, portability and relatively high sensitivity to

visual disturbance corresponding to that in the macular

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