A 24-year-old man has unaided visual acuity of 6/60 in the right eye. Looking through a pinhole disc held before the eye, his acuity improves to 6/6. This finding most strongly suggests:
- A A refractive error as the cause of reduced vision ✓
- B An optic nerve disorder
- C A macular lesion
- D Early cataract
Correct answer: A. A refractive error as the cause of reduced vision
Explanation
The pinhole allows only central, nearly parallel rays to reach the retina, effectively eliminating the need for focusing. Vision that normalizes through a pinhole therefore points to uncorrected refractive error as the cause of the acuity loss. Media opacities such as cataract may improve variably but usually not to 6/6, while macular and optic nerve disease produce organic deficits that a pinhole cannot overcome. The pinhole test is a standard bedside separator of refractive from organic causes.
Reference: Parsons' Diseases of the Eye, 23rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.