For orthoptists and eye-care clinicians

Orthoptic assessment

Structured, bilingual assessment forms for the orthoptic examination. Fill them in during the exam, save them to the patient’s record, or print them as the paper form for signature.

The assessments

12 sections45 min

Neurovisual assessment

Structured Clinical Assessment Form

History, acuity, alignment and motility, eye movement systems, binocular status, fields and higher visual function, with red flags for urgent referral.

  1. History & Symptom Characterisation
  2. Visual Acuity & Afferent Function
  3. Ocular Alignment & Motility
  4. Eye Movement Systems
  5. Nystagmus & Abnormal Eye Movements
  6. Binocular Sensory Status
  7. Visual Fields
  8. Higher Visual & Attentional Function
  9. Associated & Structural Examination
  10. Functional & Symptom-Impact Measures
  11. Synthesis, Localisation & Plan
  12. Conclusion

Includes a red-flag checklist for urgent referral

8 sections60 min

Low vision assessment, adult

Functional Vision & Rehabilitation Assessment

Functional goals, acuity and refraction, contrast and glare, fields, magnification and aids, reading performance, and the rehabilitation plan.

  1. History & Functional Goals
  2. Visual Acuity & Refraction
  3. Contrast, Glare & Lighting
  4. Visual Fields & Scanning
  5. Magnification & Low Vision Aids
  6. Reading Performance
  7. Plan, Rehabilitation & Referral
  8. Conclusion
6 sections60 min

Low vision assessment, paediatric

Functional Vision, Development & Educational Needs

Developmental history, functional vision observation, acuity, educational and classroom needs, and the plan agreed with the family.

  1. Developmental & Medical History
  2. Functional Vision Observation
  3. Acuity & Visual Function
  4. Educational & Learning Needs
  5. Plan, Support & Referral
  6. Conclusion

How it works in clinic

Pre-filled from the patient record
Name, date of birth, age, examiner and clinic are entered for you when a patient is selected.
Saved to the patient’s file
Each completed assessment is kept with the patient’s test results, ready to reopen, download as CSV or print.
Print or save as PDF
The form prints as a clean paper sheet with signature and date lines, for the clinical file or a referral letter.
English and French
Switch language at any time without losing what has been entered. The saved report keeps the language it was written in.

Questions

What is an orthoptic assessment?

An orthoptic assessment (bilan orthoptique) is a structured examination of binocular vision, eye alignment and eye movements, and of how vision is used day to day. It records the history, visual acuity, cover test and motility, convergence, stereopsis and visual fields, then a conclusion and a plan.

Who are these forms for?

Orthoptists, ophthalmologists, optometrists and low vision rehabilitation teams. They are clinical records completed by the examiner, not self-tests.

What does the neurovisual assessment cover?

History and symptoms, visual acuity and pupils, cover test and motility with localising patterns (CN III, IV, VI, INO), saccades, pursuit and vergence, nystagmus, binocular sensory status, visual fields, neglect and reading, and a red-flag checklist for urgent referral.

Is there a low vision assessment for children?

Yes. The paediatric low vision form covers developmental and medical history, functional vision observation, acuity by age-appropriate methods, learning medium and classroom adaptations, and the plan agreed with the family. A separate form covers adults.

Can I print the completed form?

Yes. Any form prints, or saves as PDF, as a paper sheet with signature and date lines. A saved assessment can also be downloaded as CSV from the patient’s file.

Use the assessments

The forms are part of VisReed Practice, the clinician workspace. Sign in to fill in, save and print them; patient records are stored against your account only.

Sign in to use them →

Clinical use within a supervised assessment, not a self-diagnostic instrument.