Questionnaire sur la vue rempli pour le dépistage automatisé de la vue Copie Copy

Completed Vision Questionnaire for Automated Vision Screening

Figure 9.5: An Example of a Completed Vision Questionnaire

Vision Screening Questionnaire – Page 1

Vision Screening Questionnaire – Page 2

Vision Screening Questionnaire – Page 3

Vision Screening Examination – Page 4

Figure 9.6: Example of a Titmus V4 / i400 Record Form4


Figure 9.7: Example of a Completed Titmus Manual Record Form3


Figure 9.8: Example of a Keystone VS-V Record Form5


Figure 9.9: Example of a Keystone VS-V Completed Record Form


Figure 9.10: Example of a Visiolite / Depisteo Manual Record Form6


Table 9.3. Summary of tests done and recorded: