The pinhole test is a simple test to help your eye doctor understand and diagnose the cause of your vision changes and determine if glasses can help.
The pinhole test really is meant to answer the question: Is there a pair of glasses that can help you see better, and if so, then how much better? It’s also one way your eye doctor can begin to diagnose macular degeneration and other eye conditions. It uses an occluder, a tool like a card or handheld patch that covers one eye so only the other eye receives light.
The occluder in a pinhole test has a tiny hole that allows you to look through it. This focuses the light on your retina and temporarily corrects or reduces refractory vision errors – like myopia (nearsightedness), hyperopia (farsightedness), or astigmatism (blurry vision) – and temporarily improves vision in the eye you are using to look through the pinhole.
If your doctor suspects macular degeneration, the pinhole test is one early way to begin the diagnostic process.
A pinhole test can tell your eye doctor if your eye condition is related to your lens or optic nerve.
Macular degeneration is a condition that affects the macula, a small area in the center of the retina.
If your vision does not temporarily improve as you look through the occluder, then that is one sign that the condition affecting your vision might be macular degeneration.
The steps of a pinhole test include:
- covering one eye while you look through a tiny hole (a pinhole) in another eye cover
- reading the smallest line you can on an eye chart while looking through the pinhole
- removing the pinhole cover from in front of your eye
- reading the smallest line you can on the eye chart
After this test, your doctor will decide if you need further testing to determine if you have a condition affecting your retina.
It depends on the pinhole test results. If the test shows that macular degeneration is likely, it’s a progressive condition, which means it will worsen, and there is no way to stop the progression.
If the pinhole test shows that the visual changes are likely due to refractive error or media opacity (like cataract), then the outlook is more positive. There are treatment options for most refractory conditions. If the test shows it may be opacity, and if the condition is determined to be cataracts, surgery is a highly effective treatment that restores vision.
If your vision improves when you look through the occluder, you have a refractory condition affecting your vision, like myopia, hyperopia, astigmatism, or presbyopia. If you have macular degeneration, your vision will worsen when you look through the pinhole.
The pinhole test can help your eye doctor know if glasses can correct your vision or if you need additional treatment.
No special preparation is needed for the pinhole test. You may want to bring your glasses or contact lenses to the test. Your eye doctor may also want to test your vision while you’re wearing them.
The pinhole test is one way for your eye doctor to tell if you might have macular degeneration. The test is simple. You will be asked to read lines on the eye chart while looking through a tiny hole in an eye cover.
The pinhole test is just one way for your doctor to determine what care you need to help improve your vision. If you have signs of macular degeneration, you will have additional diagnostic testing to help determine your treatment options.