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驗光師視力檢驗
視力檢驗報告樣本
視力檢驗
| 日期 | : |
| 姓名 | : |
| 登記號碼 | : |
| 性別 | : |
| 年齡 | : |
| 右眼 | 左眼 | ||
| Dominant Eye | : | Right | |
| Eye Pressure (<21 mmhg) | : | 15 | 12 |
| Glasses Prescription | : | -5.75/-0.50x170 6/9.6- | -6.25/-0.50x18 6/7.5- |
| Uncorrected Visual Acuity | : | 6/120 | 6/120 |
| Manual Refraction | : | -6.50/-1.00x165 6/6 | -6.75/-0.50x20 6/6 |
| Add: (Reading) | : | +1.50 | +1.50 |
| Additional Remarks | : | Needs progressive lenses |
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