For detailed information about how we measure visual acuity and visual fields for adults and children, refer to the following related adult and child references:

The following low vision visual acuity categories indicate that no optical correction will improve the claimant’s visual acuity:

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  Counts fingers (CF),

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  Hand motion (HM),

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  Light perception or light perception only (LP or LPO), and

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  No light perception (NLP).

If the claimant’s central visual acuity in an eye is recorded as CF, HM, LP or LPO, or NLP, we will determine that the claimant’s best-corrected central visual acuity is 20/200 or less in that eye.

If the claimant’s visual acuity is measured for a distance other than 20 feet, we will convert it to a 20-foot measurement. For example, if visual acuity is measured at 10 feet and is reported as 10/40, we will convert this measurement to 20/80.

We will not use the results of pinhole testing or automated refraction acuity to determine best-corrected central visual acuity. These tests provide an estimate of potential visual acuity but not an actual measurement of best-corrected central visual acuity.

When we measure the claimant’s best-corrected central visual acuity, we use visual acuity testing for distance using Snellen methodology or any other testing methodology that is comparable to Snellen methodology, such as the Bailey-Lovie and Early Treatment Diabetic Retinopathy Study (ETDRS).

Most test charts that use Snellen methodology do not have lines that measure visual acuity between 20/100 and 20/200. However, some newer test charts have lines that measure visual acuity between 20/100 and 20/200, such as the Bailey-Lovie and ETDRS.

If visual acuity is measured with one of these newer charts, and the claimant cannot read any of the letters on the 20/100 line, we will consider that the claimant has statutory blindness based on a visual acuity of 20/200 or less. For example, if best-corrected visual acuity for distance in the better eye is 20/160 using an ETDRS chart, we will find the claimant has statutory blindness.

A claimant does not have statutory blindness if he or she can read at least one letter on the 20/100 line. For example, the best-corrected visual acuity in the better eye is 20/125+1 using an ETDRS chart. The claimant does not have statutory blindness because he or she is able to read one letter on the 20/100 line.

DI 34001.012A.5.b. and DI 34005.102A.5.b.(ii) Other test charts

Infants and very young children, because of their age, cannot participate in visual acuity testing using Snellen methodology or other comparable testing. Some adults and other children may also be unable to participate in testing using Snellen methodology for other reasons, such as intellectual disability.

For infants and very young children, and for adults and other children who are unable to participate in testing using Snellen methodology or other comparable testing, we need other evidence to establish statutory blindness as discussed in DI 26001.005F.2. and DI 26001.005F.3. in this section.

For infants and very young children, we generally use listing 102.02B. Evidence we use to meet the listing may include clinical findings of fixation and visual-following behavior. If both these behaviors are absent, we will consider the anatomical findings or the results of neuroimaging, electroretinogram, or visual evoked response (VER) testing when this testing has been performed.

For additional information regarding children who are unable to participate in visual acuity testing, see DI 34005.102A.5.a.(iv) and DI 34005.102A.5.b.(i).

For adults and other children who cannot participate in testing, we need documentation of all of the following on an eye examination:

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  A detailed description of the adult’s or child’s ability to perceive light or hand movements, follow objects, accept objects offered, and recognize familiar people.

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  The findings on examination of the external eye including eyelid, external ocular movements, cornea, and sclera; and

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  The findings on examination of the interior eye (ophthalmoscopy) including anterior chamber, iris, pupil, lens, posterior chamber, and fundus (including the optic disc).

This documentation may reveal abnormal anatomical findings, if any, that indicate a visual acuity of 20/200 or less in the better eye.

When the evidence described above does not provide an adequate basis for statutory blindness, the results of neuroimaging (usually, magnetic resonance imaging) may document abnormalities in components of the neural visual pathways (optic nerve, optic chiasm, optic tract, and visual cortex), such as septo-optic dysplasia, that indicate a visual acuity of 20/200 or less in the better eye.

When neuroimaging and the routine eye examination evidence do not provide an adequate basis for statutory blindness, VER or electroretinogram testing may provide additional information for evaluating visual acuity loss for adults and children who cannot participate in testing using Snellen methodology.

Determine the testing needed on a case-by-case basis. 

Consider how the claimant's visual capability corresponds with his or her ocular pathology and, using reasonable judgment, determine whether his or her visual acuity loss meets listing 2.02 for adults, or listings 102.02A or 102.02B for children; or whether his or her visual field loss meets listing 2.03A for adults, or listing 102.03A for children.

NOTE: When the disability determination services (DDS) has a case in which the claimant cannot participate in visual acuity (or visual field) testing, and the DDS has a question about which tests are appropriate to determine visual acuity (or visual fields) for the particular case, contact the regional Center for Disability with case-specific questions for referral to the Office of Disability Policy, as appropriate.