Table 2.

Scoring Sheets for Right, Left and Both eyes

2□0.04	4□0.08	0□0.12	2□0.16	0□0.20	8□0.24
3□0.28	4□0.32	2□0.36	5□0.40	8□0.44	5□0.48
7□0.52	5□0.56	2□0.60	3□0.64	7□0.68	3□0.72
4□0.76	7□0.80	3□0.84	2□0.88	4□0.92	7□0.96
5□1.00	3□1.04	4□1.08	0□1.12	8□1.16	0□1.20
4□1.24	8□1.28	2□1.32	7□1.36	3□1.40	2□1.44
8□1.48	7□1.52	5□1.56	4□1.60	5□1.64	2□1.68
0□1.72	5□1.76	8□1.80	4□1.84	5□1.88	7□1.92
Left eye □ Right eye □ Both eyes □
Value of final correct letter: ______
Number of missing prior to stopping
______ × 0.04 = ______
Subtract
Log Contrast sensitivity = ______
4□0.04	7□0.08	3□0.12	5□0.16	8□0.20	7□0.24
3□0.28	4□0.32	7□0.36	2□0.40	7□0.44	8□0.48
5□0.52	0□0.56	2□0.60	3□0.64	0□0.68	3□0.72
0□0.76	5□0.80	4□0.84	0□0.88	8□0.92	3□0.96
4□1.00	0□1.04	2□1.08	3□1.12	7□1.16	2□1.20
8□1.24	5□1.28	7□1.32	0□1.36	2□1.40	0□1.44
7□1.48	5□1.52	2□1.56	5□1.60	3□1.64	8□1.68
2□1.72	7□1.76	4□1.80	3□1.84	4□1.88	8□1.92
Left eye □ Right eye □ Both eyes □
Value of final correct letter: ______
Number of missing prior to stopping
______ × 0.04 = ______
Subtract
Log Contrast sensitivity = ______
2□0.04	7□0.08	3□0.12	2□0.16	8□0.20	3□0.24
0□0.28	7□0.32	2□0.36	8□0.40	4□0.44	3□0.48
3□0.52	0□0.56	3□0.60	2□0.64	0□0.68	4□0.72
7□0.76	0□0.80	5□0.84	8□0.88	5□0.92	7□0.96
0□1.00	4□1.04	2□1.08	8□1.12	5□1.16	8□1.20
4□1.24	3□1.28	5□1.32	8□1.36	0□1.40	4□1.44
0□1.48	8□1.52	3□1.56	0□1.60	5□1.64	2□1.68
7□1.72	2□1.76	5□1.80	8□1.84	3□1.88	8□1.92
Left eye □ Right eye □ Both eyes □
Value of final correct letter: ______
Number of missing prior to stopping
_____ × 0.04 = ______
Subtract
Log Contrast sensitivity = ______