Ophthalmic examination & eye test - FlugMed | BERLIN - Flugmedizin (2025)

Visual acuity is the ability of the eye to see two points separately. These two points form a visual angle – the angle at the sharpest point, the reciprocal of which is the visual acuity. If the angle of vision is 1 degree, for example, then the visual acuity is 1.0 – which corresponds to 100 percent. If there is an angle of 10 degrees, the visual acuity is 0.1 – this corresponds to 10 percent. If people can see normally, they have a visual acuity of 100 percent. This test is primarily performed when nearsightedness or farsightedness is suspected and is used in the aptitude test for the driver’s license.

A refraction is the refractive power of the eye, which can be determined by specifying the distance point. This distance point determination is called refraction determination, but is also known as spectacle lens or eyeglass determination. To determine this value, there are two methods of measurement – objective and subjective refraction determination. Often, these are also combined during examinations. While the objective determination takes place without questioning the patient and is automated by a refractometer, the subjective determination takes place under questioning of the examined and is determined with measuring glasses.

A color vision test checks how well the tester recognizes colors and can distinguish between them. Genetic defects in the eyes or diseases can cause colors to be difficult to see. There is the well-known red-green weakness or the rarer yellow-blue weakness. The examination uses various color plates on which images are built up from small color dots. Patients with color vision deficiencies are usually not able to distinguish them well and cannot recognize the different color contrasts. This can have occupational implications,

Stereo vision means the ability of spatial vision. There are many different methods and examination options for this test. The Lang stereotest I and II are often used, in which the patient is presented with a test card on which small black dots show three-dimensional images. These can only be recognized if stereo vision is intact.

In practice, this test is also suitable as a rapid screening method if, for example, there is a need for is to distinguish pseudostrabismus (e.g., epicanthus) from true strabismus. In the positive case, it suggests an intact stereopsis.

The color recognition is checked accordingly to EASA with the color charts (according to Ishihar) or on the anomaloscope (according to Nagel) or with a signal lantern.

Ishihara color charts are a simple eye test with different color charts, on which colored numbers and shapes can be recognized ,- the test is installed in all common eye test devices in Europe/Germany, it is very well known and widespread. It is actually very easy to pass.

Only if color vision disorders are really present, then it is necessary, actually also another chance, – by means of further tests still another possibility to receive sufficient color vision to be able to fly attested. In case that color vision disorders are really present it bis necessary to make further tests. Passing these tests the patient has „a second chance“ to testify the sufficient color vision that is necessary to be able to fly.

Generally important to know:

The examination with the color plates must take place under good lighting conditions. Results on the anomaloscope depend on the experience of the individual examiner.

There are 3 types of lanterns allowed. Spectrolux – Holmes Wright – Beynes. These lantern types are actually very difficult to buy as medical devices at the moment…. Also the AMC`s have problems with it.

It should be noted that the individual lantern types and test conditions can lead to different results. But there is no rule which test has to be passed.

The JAA conducted an investigation at the University of London in which applicants – who had failed the Ishihara test – were tested on the 3 lanterns and the anomaloscope.

Because the 3 lanterns have different light characteristics and luminous intensity and are tested according to different protocols, and at the same time the anomaloscope according to Nagel contains a completely different test principle, the comparative test has led, as expected, to different results for the same applicants.

At the AMC in London, testing is carried out with the Holmes Wright and Beynes type. You have to pass on type of lantern test. It is first tested according to Beynes.

No need to panic if you fail this test:

In Holland, the Holmes-Wright type is available. In Zurich the Spectrolux type is used, in Cologne the Beynes type.

You only have to pass a Latern test once. No new test is required for repeat ophthalmic examinations.

Holmes-Wright lantern consists of 2 superimposed lights, which can be red, green or white. All combinations are entered, i.e. a different color at the top and bottom or the same color at the top and bottom. Beynes lantern emits 5 different lights – red – green – blue – orange – white.

The following rules apply:

  1. no error in the first round -> test passed
  2. any red – green confusion -> automatically failed
  3. another error -> 2 more rounds are completed
  4. no error in both extra rounds -> test passed
  5. Error in round 2 or 3 -> Dark adaptation
  6. no error in the dark round -> test passed
  7. any error in the dark round -> automatically failed.
Ophthalmic examination & eye test - FlugMed | BERLIN - Flugmedizin (2025)
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