| Course | PA 516 Comprehensive Clinical Module HEENT (Head, Ears, Eyes, Nose, Throat) |
|---|---|
| Week | 5 |
| Paper type | Visual acuity documentation |
| Length | About 680 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 516 Week 5
Visual Acuity Documentation for a Commercial Driver: A 20-Foot Snellen Line for Each Eye and Both Together, Glasses On, a Pinhole Gain on the Right and the Federal 20/40 Line Beside It
Student Name
Chamberlain University
PA 516: Comprehensive Clinical Module HEENT (Head, Ears, Eyes, Nose, Throat)
Instructor Name
Month Day, Year
Visual Acuity Documentation for a Commercial Driver: A 20-Foot Snellen Line for Each Eye and Both Together, Glasses On, a Pinhole Gain on the Right and the Federal 20/40 Line Beside It
Why Acuity Was Measured
T.M. holds a commercial driver's license and is due for a medical examination for interstate driving in two months. Federal rules require distant acuity of at least 20/40 in each eye separately and in both eyes together, with or without corrective lenses, along with a horizontal field of at least 70 degrees in each eye and the ability to recognize traffic signal colors (Physical Qualifications for Drivers, 2024). T.M. mentioned that road signs at night had looked blurred on the right, so acuity was measured before the next driving season rather than at the exam itself.
Chart and Distance, Declared
Chart: wall-mounted Snellen chart, black letters on a white background, lit by the chart's own lamp. Distance: 20 feet, measured with a tape from the chair to the wall. Near acuity: a handheld card at 14 inches. The room lights were on for both.
One Line per Eye
Table 1
Distance Acuity Recorded Eye by Eye With Correction and Pinhole
| Eye | Correction | Distance acuity | Pinhole |
|---|---|---|---|
| Right | Own glasses | 20/30, missed two of six letters on the 20/25 line | 20/20 |
| Left | Own glasses | 20/20 | Not tested |
| Both | Own glasses | 20/20 | Not applicable |
| Right | Unaided | 20/60 | Not tested |
| Left | Unaided | 20/50 | Not tested |
Note. Note. The other eye was covered with a handheld occluder, not the patient's fingers. Near acuity with glasses: reads the 20/25 equivalent line at 14 inches with each eye.
Pinhole Where It Applies
The pinhole was used only on the right eye, the one that fell short of 20/20. A pinhole lets through only central rays, which reduces the blur caused by an uncorrected refractive error. When acuity improves through a pinhole, the shortfall is likely refractive and new glasses may correct it; when it does not improve, the eye or the visual pathway itself may be the problem (Bickley et al., 2021). T.M.'s right eye improved from 20/30 to 20/20, so the most likely cause is a change in prescription since the glasses were made four years ago.
Conditions in Prose
T.M. squinted on the right before the pinhole was offered and was asked to stop. No reading glasses were used for distance. The occluder was moved between eyes without letting T.M. see the chart in between. Testing was done after the fundoscopic exam, without dilation.
What the Record Does Not Say
It does not say T.M. meets the federal standard; that decision belongs to the certified medical examiner at the scheduled visit, who also tests fields and color. It does not say the right eye is healthy, since the fundus exam last week reached only the disc. It does say the corrected acuity in each eye and in both is well above the 20/40 line and that the right eye's shortfall corrects with a pinhole. T.M. was referred for a refraction at the optometry visit already booked for retinal photographs, so both can be done the same day.
Comparison With the Prior Record
The work physical two years ago recorded 20/20 in each eye with glasses but did not name the chart, the distance or whether the other eye was covered properly. That record cannot be compared line by line with today's. The most it supports is that corrected acuity in the right eye was at least as good then as now, and probably better. Today's entry is written so that the next comparison will be possible: the same chart, distance, occluder and correction can be used again, and any further loss in the right eye will show up as a measurable change rather than an impression.
References
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates' guide to physical examination and history taking (13th ed.). Wolters Kluwer.
Physical Qualifications for Drivers, 49 C.F.R. ยง 391.41 (2024). https://www.ecfr.gov/current/title-49/subtitle-B/chapter-III/subchapter-B/part-391/subpart-E/section-391.41
PA 516 Week 5 instructions, in plain terms
Week five asks for visual acuity documented so that another clinician could repeat it. State why acuity was tested, since the purpose decides what has to be recorded. Name the chart and the testing distance, and describe the lighting. Give each eye its own line and add a line for both eyes together, with correction status on every line: unaided, own glasses or contact lenses. Where a line was partly read, record how many letters were missed. Use a pinhole for any eye that falls short and record whether it helped. Add near acuity if relevant. Describe testing conditions in a short paragraph, including anything that might have helped or hurt the result. Finish with what the record does and does not establish, and cite any standard the result is measured against.
How this PA 516 Week 5 example is built
The paper explains that T.M. must pass a federal driver medical exam in two months and cites the rule on acuity of at least 20/40 in each eye, field of vision and color recognition. Chart, 20-foot taped distance and lighting are declared. Table 1 gives 20/30 on the right with two letters missed on the next line, 20/20 on the left and together with glasses, unaided figures of 20/60 and 20/50, and a pinhole result of 20/20 on the right. A pinhole section cites Bates' guide on what improvement suggests. Conditions note the squint that was stopped and the handheld occluder. A comparison section explains why an old work physical cannot be matched line by line, and the closing section leaves certification to the medical examiner and books a refraction.
Where the points sit in the PA 516 Week 5 rubric
Precision of notation carries most of the marks here. A fraction without the eye, the correction status or the chart and distance is treated as unusable and loses heavily. Faculty next look for both eyes recorded separately and together, since many records skip the binocular line. Partial lines must show the letters missed, not a rounded result. Credit goes to a pinhole used where it applies and correctly interpreted as refractive or not. The conditions paragraph earns marks when it records factors such as squinting or an improper occluder. Deductions follow for claiming fitness to drive or pass a standard the clinician is not certified to judge. Any rule or guideline mentioned must be cited and referenced in APA format, and tables need a number, title and note.
PA 516 Week 5 help: mistakes that cost points
The usual problem with acuity records is a single fraction with nothing to say how it was obtained. Send your case details, the chart your clinic uses and the reason for the test, and the custom sample will lay out each eye and both together with correction status on every line. Partial lines, pinhole results and near acuity are added where your case calls for them. If a standard applies, such as a driving, school or occupational rule, the sample cites it without claiming a fitness decision that belongs to someone else. A short paragraph on testing conditions is written from your scenario. If an older record exists, the sample explains how to compare it fairly. Recheck every figure against your own case notes before borrowing the layout.
Get a PA-516 Week 5 example written to your instructions
Send the Week 5 instructions and the notation format your classroom specified, and a custom PA-516 acuity record is written in that format and returned inside 24 to 48 hours, first one at no charge. Sections differ on pinhole thresholds and on which abbreviations they accept, so send the template if one was posted.
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PA 516 Week 5 questions, answered
Does every line need a pinhole result?
Only where the acuity was reduced, and your classroom usually names the threshold. Finished records include it there and say so explicitly rather than leaving the space blank, because a blank reads as a test never performed. Where the section sets no threshold, the example states the one it used so a grader can follow the decision without guessing at it.
What if the patient could not read the chart at all?
Then the record moves down the sequence the classroom specifies and documents the step reached, in that section's own abbreviations. Finished examples name what was attempted before the drop, the distance used, and the conditions at the time. What loses points is a blank line or the word poor, neither of which tells a reader what the patient could actually resolve.
Is the narrative paragraph really marked?
In most sections it is, and it tends to be where the difference between two otherwise identical records shows up. It holds the things that shaped the fractions: the lighting, the glasses that were not the patient's own, the leaning, the guessing. Rubrics generally reward a short factual account there rather than an interpretation of the result.
Where can I find a free PA 516 Week 5 sample paper?
This page holds the complete PA 516 Week 5 acuity record for a truck driver, each eye and both together, with correction status and a pinhole result.
What does the pinhole result mean in the PA 516 Week 5 sample?
The right eye improved from 20/30 to 20/20 through the pinhole, which points to an outdated glasses prescription rather than disease, so a refraction was booked.