A pinhole occluder is an opaque disk with one or more small holes through it, used by

ophthalmologist Ophthalmology ( ) is a surgery, surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Followin ...

s, orthoptists and

optometrists Optometry is a specialized health care profession that involves examining the eyes and related structures for defects or abnormalities. Optometrists are health care professionals who typically provide comprehensive primary eye care. In the Uni ...

to test

visual acuity Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an examinee's ability to recognize small details with precision. Visual acuity is dependent on optical and neural factors, i.e. (1) the sharpness of the retinal ...

. The occluder is a simple way to focus light, as in a

pinhole camera A pinhole camera is a simple camera without a lens but with a tiny aperture (the so-called ''pinhole'')—effectively a light-proof box with a small hole in one side. Light from a scene passes through the aperture and projects an inverted image o ...

, temporarily removing the effects of

refractive error Refractive error, also known as refraction error, is a problem with focus (optics), focusing light accurately on the retina due to the shape of the human eye, eye and or cornea. The most common types of refractive error are myopia, near-sightedne ...

s such as

myopia Near-sightedness, also known as myopia and short-sightedness, is an eye disease where light focuses in front of, instead of on, the retina. As a result, distant objects appear blurry while close objects appear normal. Other symptoms may include ...

. Because light passes only through the center of the eye's lens, defects in the shape of the lens (errors of refraction) have no effect while the occluder is used. In this way, the ophthalmologist, orthoptist or optometrist can estimate the maximum improvement in a patient's vision that can be attained by lenses to correct errors of refraction. This can be used to distinguish visual defects caused by refractive error, which improve when the occluder is used, from other problems, which do not. The pinhole occluder can also be used in testing visual acuity in

mydriatic Mydriasis is the dilation of the pupil, usually having a non-physiological cause, or sometimes a physiological pupillary response. Non-physiological causes of mydriasis include disease, trauma, or the use of certain types of drugs. Normally, as ...

patients. In this case, the pinhole occluder compensates for the inability to contract the iris assisting the eye in obtaining a retinal projection similar to that of a non-cycloplegic eye. Squinting and looking through a tiny hole made with a finger works similarly to a pinhole occluder, by blocking light through the outer parts of the eye's lens. An improvised pinhole has a similar but better effect. The same principle has also been applied as an alternative to corrective lenses: a screen of pinholes is mounted on an eyeglass frame and worn as

pinhole glasses Pinhole glasses, also known as stenopeic glasses, are eyeglasses with a series of pinhole-sized perforations filling an opaque sheet of plastic in place of each lens. Similar to the workings of a pinhole camera, each perforation allows only a very ...

. Differential diagnosis: * * pinhole worsen vision: Macular diseases, central lens opacities
* Vision static with pinhole:

Amblyopia Amblyopia, also called lazy eye, is a disorder of sight in which the brain fails to fully process input from one eye and over time favors the other eye. It results in decreased vision in an eye that typically appears normal in other aspects. Amb ...

References

{{reflist Diagnostic ophthalmology Optometry