Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What does improved acuity with the pinhole indicate in a patient?

1. That there are no refractive issues

2. That there is a retinal problem

3. That there is an uncorrected or under-corrected refractive error

4. That the patient has amblyopia

The correct answer is: That there is an uncorrected or under-corrected refractive error

Improved acuity with the pinhole test is indicative of an uncorrected or under-corrected refractive error. The pinhole test works by allowing only direct rays of light to enter the eye, which helps to increase depth of focus and reduce the effects of any refractive errors present. When a patient shows better vision through the pinhole, it suggests that their vision loss is due to a refractive error that has not been fully corrected with glasses or contact lenses. In contrast, if there are no refractive issues present, one would not expect significant changes in visual acuity with a pinhole. Additionally, if the patient had a retinal problem, improvement in visual acuity would likely not occur with the use of a pinhole, as this test does not address issues related to the retina itself. Lastly, while amblyopia can cause reduced visual acuity, the pinhole test typically does not lead to improvement in cases of true amblyopia, which is more about the brain's processing of visual signals rather than a simple refractive error. Thus, the correct interpretation when acuity improves with the pinhole is that there is likely an uncorrected or under-corrected refractive error.