Can You Use an Amsler Grid on Your Phone for Macular Checks?

Amsler grid test for macular assessment?

Hello, Doctor.
I have a few questions I would like to ask!
1.
Can I use the Amsler grid on my smartphone to check for macular issues? I am viewing the image on my phone at a distance of about 30 centimeters: http://health99.hpa.gov.tw/OnlinkHealth/images/amsler_list.jpg.
When I look at this grid on my phone, I wear my glasses and also try without them.
Closing my right eye, I focus on the central black dot with my left eye and move horizontally to the right until I reach the edge of the grid.
I notice distortion to the left of the central black dot.
Similarly, when I focus with my right eye and move to the left edge, I see distortion to the right of the central black dot.
However, when I look at the grid with both eyes focused only on the central black dot, I do not see any distortion.
2.
Does this situation indicate a problem with the macula, or could it be an issue with the smartphone display?
3.
If I print out the Amsler grid and perform the same test, moving my focus to the right and left edges, and do not observe the same distortion as on the phone, should I consider the printed grid as the accurate assessment?
4.
I recently had a dilated fundus examination at the hospital, which showed no issues.
If there were any problems with the macula, would they be detectable during the fundus examination, regardless of severity? I am nearsighted, with both eyes around -5.00 diopters, and my left eye has -0.70 astigmatism while my right eye has -0.15 astigmatism.
Thank you for your answers!

A Yan, 30~39 year old female. Ask Date: 2018/06/06

Dr. He Jianxian reply Ophthalmology

The correct method for using the Amsler grid is to focus on the central black dot and observe whether there is any distortion of straight lines in the visual field.
It is recommended to print it on paper for more accurate testing.

Reply Date: 2018/06/06

More Info

Using an Amsler grid on your phone for macular checks can be a convenient option, but there are several important considerations to keep in mind regarding accuracy and reliability.
1. Using Amsler Grid on a Phone: While it is technically possible to use an Amsler grid displayed on a smartphone, it is not the ideal method for conducting this test. The Amsler grid is designed to be printed on a standard piece of paper (typically 10 cm x 10 cm) and viewed from a distance of about 30 cm. The resolution and size of the grid on a phone screen may not accurately represent the grid's dimensions, which can lead to misleading results. Additionally, the brightness and color settings of your phone can affect how you perceive the grid, potentially causing distortions that are not related to your vision.

2. Interpreting Distortions: The distortions you observe when moving your gaze across the grid could indicate a problem with your macula, particularly if you see wavy or distorted lines. However, it is also possible that the distortions are a result of the screen's display characteristics or your visual acuity, especially if you are not wearing corrective lenses. If you notice consistent distortions when using the grid on your phone, it is advisable to conduct the test using a printed version to confirm your findings.

3. Printed Amsler Grid vs. Phone Version: If you conduct the Amsler grid test using a printed version and do not see the same distortions as you did on your phone, it is reasonable to trust the printed version more. The printed grid provides a standardized format that is less likely to be influenced by screen size, resolution, or lighting conditions. It is crucial to ensure that the printed grid is of the correct size and that you are viewing it from the appropriate distance.

4. Eye Examination and Macular Health: If you have recently undergone a dilated eye exam and your doctor found no issues, it is a positive sign. However, if you are experiencing new symptoms, such as distortion in your vision, it is essential to follow up with your eye care provider. While some macular issues can be detected during a routine eye exam, subtle changes may not be immediately apparent. Regular monitoring, especially for individuals with high myopia (like your 500-degree prescription), is crucial, as they are at a higher risk for conditions such as macular degeneration or retinal detachment.

In summary, while using an Amsler grid on your phone can provide some insights, it is not a substitute for a proper eye examination or a printed grid test. If you notice any changes in your vision, especially with your history of high myopia, it is advisable to consult your eye care professional for further evaluation. Regular eye exams and monitoring are key to maintaining eye health, especially for those at risk for macular and retinal conditions.

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