Archetype : openEHR-EHR-OBSERVATION.visual_acuity

Modellbiblioteket openEHR Fork

Name

Visual acuity test result

Description

Visual acuity is a measure of the spatial resolution of the visual processing system.

Keywords

eye sight vision ophthalmic visual refraction

Purpose

For recording the results of both near and distance visual acuity testing, normally measured by testing the subject's ability to read a standard test pattern at a defined distance.

Use

Use to record the results of measurement of visual acuity, for both near and distance testing.

The 'Clinical Description' data element can be used to record simple narrative summary or as a means to integrate legacy data.

Detailed, structured visual acuity results are preferred and are generally recorded for each eye in turn. Visual acuity may be recorded using a number of different notation formats e.g. Snellen, logMar, EDTRS etc. In some settings the visual acuity result, originally captured using one of the standard notations, is converted to a 'Derived Score' capable of algorithmic conversion to the other notations., with details of the original notation and algorithm employed recorded as part of protocol.

Where visual acuity is recorded using coded terms such as 'Visual Acuity 6/6' or 'Jaeger score N1', the 'Clinical Interpretation' element should be used, allowing the result to be captured for each eye. 'Overall Interpretation' should be used where the interpretation applies to both eyes or the test result as a whole.

The 'Absent Test Result' element may be used to record circumstances where a test could not be performed or completed. Further details may be recorded under 'Confounding Factors' or 'Additional Comment'.

When performing visual acuity testing it is customary to record a series of tests sharing a common charting methodology but with different phases of corrective refraction e.g. Unaided, Usual correction, Best corrected visual acuity etc. Each of these phases should be recorded using a separate Entry record, with the name of the test phase carried in 'Test Name'. Further specific details of the exact correction applied (which may involve applying multiple refractions) may be captured in 'Refractive Correction' and 'Refraction Details' the latter making use of separate Cluster archetypes, one for each eye.

Misuse

Where details of methodology carried under protocol change between phases of the visual acuity test, a new Entry must be created at run-time.

References

Visual Acuity [Internet]. Wikipedia. Available from: http://en.wikipedia.org/wiki/Visual_acuity

Aylward W [Internet].Coding Visual Acuity, openEyes Project;2012.Available from http://www.openeyes.org.uk/documents/OpenEyes%20Coding%20Visual%20Acuity.pdf

IHE Eye Care Domain. General Eye Evaluation (GEE) [Internet]. IHE; 2012. Available from: http://www.ihe.net/Technical_Framework/upload/IHE_EyeCare_Supp_GEE_Rev1-1_TI_2012-06-29.pdf

Royal College of Opthalmologists. Cataract National Dataset for Adults [Internet]. 2011. Available from: http://www.rcophth.ac.uk/page.asp?section=583&sectionTitle=Cataract+National+Data+Set+for+Adults

Laidlaw D a. H, Tailor V, Shah N, Atamian S, Harcourt C. Validation of a computerised logMAR visual acuity measurement system (COMPlog): comparison with ETDRS and the electronic ETDRS testing algorithm in adults and amblyopic children. Br J Ophthalmol [Internet]. 2008 Feb 1 [cited 2012 Sep 26];92(2):241–4. Available from: http://bjo.bmj.com/content/92/2/241

CfH, UK. Do Once & Share - Glaucoma [Internet]. [cited 2012 Sep 26]. Available from: http://www.doasglaucoma.org/

DICOM Supplement 30 [Internet]. [cited 2012 Sep 26]. Available from: http://medical.nema.org/

Chiang MF, Boland MV, Brewer A, Epley KD, Horton MB, Lim MC, et al. Special Requirements for Electronic Health Record Systems in Ophthalmology. Ophthalmology [Internet]. 2011 Aug [cited 2012 Sep 26];118(8):1681–7. Available from: http://www.aaojournal.org/article/S0161-6420(11)00374-5/abstract

Practical Ophthalmology: A Manual for Beginning Residents, 6th Edition [Paperback]

American Academy Of Ophthalmology (Author), Fred M. Wilson II (Editor), MD (Editor)

Archetype Id

openEHR-EHR-OBSERVATION.visual_acuity.v0

Licencing

This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.

Original Author

Ian McNicoll
Ocean Informatics, UK

Date Originally Authored

For recording the results of both near and distance visual acuity testing, normally measured by testing the subject's ability to read a standard test pattern at a defined distance.

Language	Details
Norwegian Bokmal	Ingrid Heitmann, Arne Løberg Sæter Oslo universitetssykehus HF
Spanish (Chile)	Poblete Francisco DuocUC

Name	Card	Type	Description
Test name	0..1	CHOICE OF DV_CODED_TEXT DV_TEXT	The name of the exact visual acuity test performed. This generally represents a broad category of applied refraction. Specific refraction details can be described using 'Refractive Correction'. Comment Details of the exact correction applied, or where multiple corrections should be captured via 'Refractive Correction'. Constraint for DV_CODED_TEXT Pinhole visual acuity [The test is performed with pinhole refraction applied.] Usual corrected visual acuity [The test is performed with the patient's usual refractive correction i.e spectacles or contact lenses.] Best corrected visual acuity [The test is performed with the patient's optimal refractive correction.] Unaided visual acuity [The test was performed without visual aid.]
Description	0..1	DV_TEXT	An overall narrative description of the visual acuity test result.
Result details	0..2	CLUSTER	Details of the visual field test result for each eye. CLUSTER
Eye examined	1..1	DV_CODED_TEXT	The eye which is being examined. Constraint for DV_CODED_TEXT Left eye [The test result refers to the visual acuity of the left eye only.] Right eye [The test result refers to the visual acuity of the right eye only.] Both eyes simultaneously [Both eyes were examined simultaneously.]
Notation	0..1	CLUSTER	Details of a visual acuity result recorded using one of the result notation formats. CLUSTER
Metric Snellen	0..1	DV_PROPORTION	The distance test result, recorded in Snellen format expressed in metres, where 6/6 is regarded as normal. Comment Examples: '6/6, '6/12', '6/5' DV_PROPORTION
US Snellen	0..1	DV_PROPORTION	The distance test result, recorded as Snellen visual acuity expressed in feet, where 20/20 is regarded as normal. Comment Examples: '20/20' , '20/40', '20/18' DV_PROPORTION
Decimal Snellen	0..1	DV_PROPORTION	The distance test result,recorded as Sn ellen visual acuity expressed as a decimal ratio, where 1.0 is regarded as normal. DV_PROPORTION
ETDRS Letters	0..1	DV_COUNT	Visual acuity expressed using ETDRS Letters format, with a value of 100 regarded as normal. Constraint for DV_COUNT min: >= 1; max: <= 120
logMar	0..1	DV_QUANTITY	The test result, recorded as logMar visual acuity, where a value of 0 is regarded as normal. DV_QUANTITY
Low Vision Score	0..1	DV_ORDINAL	Graded scale used when patient has low levels of visual acuity. Constraint for DV_ORDINAL 1 : NPL - No perception of light 2 : PL - Perception of light 3 : HM - Hand movement 4 : CF - Count fingers
Letter Termination Adjustment	0..1	DV_COUNT	A line termination adjustment score applied to the visual acuity result. Comment If the patient can read at least half of the chart line the visual acuity terminatin line is recorded as that line, with the number of letters missed on that line recorded as a negative Letter Termination Adjustment score. If the patient can read less than half of a Visual Acuity line, the previous line is recorded as the Visual Acuity result, with the number of letters seen on the following line recorded as a positive 'Letter Termination Adjustment' score. Constraint for DV_COUNT min: >= -10; max: <= 10
Derived Score	0..1	DV_COUNT	Visual acuity expressed as an integer score which is calculated from one or more of the other result notation formats. The original notation should be captured using 'Derived Score Original Notation' format'. Comment Details of the algorithm used and original result format may be recorded under 'Derived Score Methodology'. Constraint for DV_COUNT min: >= 0
Interpretation	0..*	DV_TEXT	Clinical interpretation of all results for the test eye. Comment Example: 'Visual Acuity 20/20' or 'Jaeger 'J2' score'.
No test result	0..1	DV_BOOLEAN	No visual acuity test result is available for the test eye. Comment Record as True if the clinician was unable to record a result for the test eye. Constraint for DV_BOOLEAN
Reason for no test result	0..1	DV_TEXT	Reason why no visual acuity test result is available for the test eye. Comment For example, patient was not cooperative; patient was not capable; ran out of time.
Overall Interpretation	0..*	DV_TEXT	A term, commonly coded, expressing an overall interpretation of the visual acuity test.
Comment	0..1	DV_TEXT	Any additional narrative comment about the visual acuity test.
Test not done	0..*	Slot (Cluster)	Details to explicitly record that this test was not performed. Slot Slot

Name	Card	Type	Description
Testing Distance	0..1	DV_QUANTITY	The distance at which the subject's visual acuity was measured. DV_QUANTITY
Chart Method	0..1	DV_CODED_TEXT	The charting method used to measure visual acuity. Constraint for DV_CODED_TEXT logMar chart [A logMar chart was used to measure distance visual acuity.] Snellen chart [A Snellen chart was used to measure distance visual acuity.] ETDRS chart [An ETDRS chart was used to measure distance visual acuity.] Picture chart [A picture chart was used to measure distance visual acuity.] Reduced logMar [A Reduced logMar chart was used to measure near visual acuity.] Reduced Snellen [A Reduced Snellen chart was used to measure near visual acuity.] Faculty of Ophthalmologists 'N' Score [Faculty of Ophthalmologists 'N' Score chart was used to measure near visual acuity.] Jaeger 'J' Score [A Jaeger 'J' Score chart was used to measure near visual acuity.]
Chart Optotype	0..1	DV_CODED_TEXT	The style of chart optotype used to assess visual acuity. Constraint for DV_CODED_TEXT Letter [A letter optotype was used to measure distance visual acuity.] Orientation [An orientation optotype was used to measure distance visual acuity.] Picture [A picture optotype was used to measure distance visual acuity.]
Chart Scoring Algorithm	0..1	DV_CODED_TEXT	The alogrithm used to determine the score. Constraint for DV_CODED_TEXT Single letter [A single letter algorithm was used to derive the visual acuity score.] Whole line [A whole line algorithm was used to derive the visual acuity score.] Last line single letter [A last line single letter algorithm was used to derive the visual acuity score.]
Measurement Device Details	0..1	Slot (Cluster)	Details of the device used to measure visual acuity. Slot Slot
Derived Score Original Notation	0..1	DV_CODED_TEXT	The original visual acuity result notation from which the Derived Score was calculated. Comment When the visual acuity result is recorded using a Derived Score, this element can be used to record the original notation format, so that it can be displayed using the original notation. Constraint for DV_CODED_TEXT US Snellen [The distance test result, recorded as Snellen visual acuity expressed in feet, where 20/20 is regarded as normal.] Metric Snellen [The distance test result, recorded in Snellen format expressed in metres, where 6/6 is regarded as normal.] Decimal Snellen [The distance test result,recorded as Sn ellen visual acuity expressed as a decimal ratio, where 1.0 is regarded as normal.] ETDRS Letters [Visual acuity expressed using ETDRS Letters format, with a value of 100 regarded as normal.] Low Vision Score [Graded scale used when patient has low levels of visual acuity.] logMar [The test result, recorded as logMar visual acuity, where a value of 0 is regarded as normal.]
Derived Score Algorithm	0..1	DV_TEXT	Details of the algorithm used to calculate a derived score.
Extension	0..*	Slot (Cluster)	Additional information required to capture local content or to align with other reference models/formalisms. Comment For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents. Slot Slot

archetype (adl_version=1.4; uid=93b051f7-c9a6-4728-92aa-13a3af7114d5)
	openEHR-EHR-OBSERVATION.visual_acuity.v0

concept
	[at0000]	-- Visual acuity test result
language
	original_language = <[ISO_639-1::en]>
	translations = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			author = <
				["name"] = <"Ingrid Heitmann, Arne Løberg Sæter">
				["organisation"] = <"Oslo universitetssykehus HF">
				["email"] = <"iheitman@ous-hf.no, arnelsa@gmail.com">
			>
		>
		["es-cl"] = <
			language = <[ISO_639-1::es-cl]>
			author = <
				["name"] = <"Poblete Francisco">
				["organisation"] = <"DuocUC">
				["email"] = <"openehrfpoblete@gmail.com">
			>
			accreditation = <".">
		>
	>
description
	original_author = <
		["name"] = <"Ian McNicoll">
		["organisation"] = <"Ocean Informatics, UK">
		["email"] = <"ian.mcnicoll@oceaninformatics.com">
		["date"] = <"2012-07-18">
	>
	details = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			purpose = <"For registering av funn ved undersøkelse av skarpsyn (visus), både nær- og avstandsmåling. Skarpsyn (visus) undersøkes vanligvis som en evaluering av et individs kapasitet til å lese en standard test ved en definert avstand.">
			use = <"Benyttes ved registering av resultater etter gjennomført undersøkelse av et individs skarpsyn (visus), både ved nær- og avstandsmåling. 

Tekstlige beskrivelser av kliniske funn innhentet fra eksisterende kliniske systemer kan fanges opp ved å benytte dataelementet \"Beskrivelse\". 

Detaljerte og strukturerte undersøkelsesresultater for skarpsyn (visus) foretrekkes og disse er vanligvis dokumentert pr øye. Skarpsyn (visus) kan registreres med forskjellige notasjoner, for eksempel Snellen, logMar, EDTRS etc. I enkelte tilfeller vil skarpsynsmålingen registrert i en standardisert notasjon, bli konvertert til en utledet skåring, som brukes inn i en algoritmisk konvertering til andre notasjoner. Detaljer om den opprinnelige notasjonen og algoritmen brukt vil bli registrert i protokollen. 

Der hvor skarpsynet (visus) er kodet med for eksempel \"Skarpsyn 6/6\" eller \"Jaeger N1\", skal dataelementet \"Fortolkning\" benyttes slik at undersøkelsesresultater kan registreres pr øye. \"Overordnet fortolkning\" skal brukes når undersøkelsesresultatet gjelder for begge øyne eller for undersøkelsen som helhet. 

Dataelementet \"Fravær av undersøkelsesresultat\" brukes for registrering av tilfeller der en undersøkelse ikke er kunne ferdigstilles eller fullføres. Ytterligere detaljer registreres i \"Konfunderende faktorer\" eller \"Kommentar\".

Ved gjennomføring av synsskarphetsundersøkelse (visusmåling) er det standard å registrere et sett av testresultater med en felles tavlemetodikk men med forskjellige faser av korrigerende refraksjon, for eksempel ukorrigert, standard korreksjon, beste korreksjon etc. Hver fase bør registreres i separate Entry-registreringer, hvor navn på standard test registreres i \"Undersøkelsesnavn\". Ytterligere informasjon om spesifikk refraksjon (som kan inkludere flere refraksjoner) beskrives i \"Refraksjonskorreksjon\" eller \"Refraksjonsdetaljer\". \"Refraksjonsdetaljer\" benytter seg av Cluster-arketype, en for hvert øye.">
			keywords = <"øye", "syn", "oftalmologi", "visuell", "refraksjon", "øyeutredning">
			misuse = <"Skal ikke anvendes der undersøkelsesmetode endres ved protokollbytte i de forskjellige fasene av synsskarphetsundersøkelsen (visusmålingen): Til dette formål må en ny Entry etableres i run-time.">
		>
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"For recording the results of both near and distance visual acuity testing, normally measured by testing the subject's ability to read a standard test pattern at a defined distance.">
			use = <"Use to record the results of measurement of visual acuity, for both near and distance testing.

The 'Clinical Description' data element can be used to record simple narrative summary or as a means to integrate legacy data. 

Detailed, structured visual acuity results are preferred and are generally recorded for each eye in turn.  Visual acuity may be recorded using a number of different notation formats e.g. Snellen, logMar, EDTRS etc. In some settings the visual acuity result, originally captured using one of the standard  notations, is converted to a 'Derived Score' capable of algorithmic conversion to the other notations., with details of the original notation and algorithm employed recorded as part of protocol.

Where visual acuity is recorded using coded terms such as 'Visual Acuity 6/6' or 'Jaeger score N1', the 'Clinical Interpretation' element should be used, allowing the result to be captured for each eye. 'Overall Interpretation' should be used where the interpretation applies to both eyes or the test result as a whole.

The 'Absent Test Result' element may be used to record circumstances where a test could not be performed or completed. Further details may be recorded under 'Confounding Factors' or 'Additional Comment'.

When performing visual acuity testing it is customary to record a series of tests sharing a common charting methodology but with different phases of corrective refraction e.g. Unaided, Usual correction, Best corrected visual acuity etc. Each of these phases should be recorded using a separate Entry record, with the name of the test phase carried in 'Test Name'. Further specific details of the exact correction applied (which may involve applying multiple refractions) may be captured in 'Refractive Correction' and 'Refraction Details'  the latter making use of separate Cluster archetypes, one for each eye.">
			keywords = <"eye", "sight", "vision", "ophthalmic", "visual", "refraction">
			misuse = <"Where details of methodology carried under protocol change between phases of the visual acuity test, a new Entry must be created at run-time.">
			copyright = <"© openEHR Foundation">
		>
		["es-cl"] = <
			language = <[ISO_639-1::es-cl]>
			purpose = <"Para registrar los resultados de las pruebas de agudeza visual cercanas y lejanas, normalmente se mide al probar la capacidad del sujeto para leer un patrón de prueba estándar a una distancia definida">
			use = <"Cuando la agudeza visual se registra utilizando términos codificados como \"Agudeza Visual 6/6\" o \"Puntuación Jaeger N1\", se debe utilizar el elemento de \"Interpretación Clínica\", lo que permite capturar el resultado de cada ojo. Se debe usar \"interpretación general\" cuando la interpretación se aplica a ambos ojos o al resultado de la prueba como un todo.

El elemento 'Resultado de la prueba ausente' se puede usar para registrar circunstancias en las que una prueba no pudo realizarse o completarse. Se pueden registrar más detalles en 'Factores de confusión' o 'Comentario adicional'.

Al realizar pruebas de agudeza visual, es costumbre registrar una serie de pruebas que comparten una metodología de gráficos común pero con diferentes fases de refracción correctiva, p. Sin ayuda, corrección habitual, mejor agudeza visual corregida, etc. Cada una de estas fases se debe registrar utilizando un registro de entrada separado, con el nombre de la fase de prueba llevada en 'Nombre de prueba'. Se pueden capturar más detalles específicos de la corrección exacta aplicada (que puede implicar la aplicación de refracciones múltiples) en \"Corrección de refracción\" y \"Detalles de la refracción\", el último haciendo uso de arquetipos de conglomerados separados, uno para cada ojo.
">
			keywords = <"ojo,", "vista,", "visión,", "oftálmico,", "visual,", "refracción">
			misuse = <"Cuando los detalles de la metodología llevada a cabo bajo el protocolo cambian entre las fases de la prueba de agudeza visual, se debe crear una nueva Entrada en el tiempo de ejecución.">
		>
	>
	lifecycle_state = <"in_development">
	other_contributors = <"Bill Aylward, openEyes Project, UK", "Gustavo Bacelar-Silva, Brazil (Editor)", "Stephen Chu, NeHTA, Australia", "Alistair Laidlaw, Guys and St Thomas NHS Trust, UK", "Heather Leslie, Ocean Informatics, Australia", "Gustavo M Bacelar-Silva, Brazil", "Mike Mair, Timaru Eye Clinic, New Zealand", "Ian McNicoll, Ocean Informatics, United Kingdom (Editor)">
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.">
		["custodian_organisation"] = <"openEHR Foundation">
		["references"] = <"Visual Acuity [Internet]. Wikipedia. Available from: http://en.wikipedia.org/wiki/Visual_acuity

Aylward W [Internet].Coding Visual Acuity, openEyes Project;2012.Available from http://www.openeyes.org.uk/documents/OpenEyes%20Coding%20Visual%20Acuity.pdf

IHE Eye Care Domain. General Eye Evaluation (GEE) [Internet]. IHE; 2012. Available from: http://www.ihe.net/Technical_Framework/upload/IHE_EyeCare_Supp_GEE_Rev1-1_TI_2012-06-29.pdf

Royal College of Opthalmologists. Cataract National Dataset for Adults [Internet]. 2011. Available from: http://www.rcophth.ac.uk/page.asp?section=583§ionTitle=Cataract+National+Data+Set+for+Adults

Laidlaw D a. H, Tailor V, Shah N, Atamian S, Harcourt C. Validation of a computerised logMAR visual acuity measurement system (COMPlog): comparison with ETDRS and the electronic ETDRS testing algorithm in adults and amblyopic children. Br J Ophthalmol [Internet]. 2008 Feb 1 [cited 2012 Sep 26];92(2):241–4. Available from: http://bjo.bmj.com/content/92/2/241

CfH, UK. Do Once & Share - Glaucoma [Internet]. [cited 2012 Sep 26]. Available from: http://www.doasglaucoma.org/

DICOM Supplement 30 [Internet]. [cited 2012 Sep 26]. Available from: http://medical.nema.org/

Chiang MF, Boland MV, Brewer A, Epley KD, Horton MB, Lim MC, et al. Special Requirements for Electronic Health Record Systems in Ophthalmology. Ophthalmology [Internet]. 2011 Aug [cited 2012 Sep 26];118(8):1681–7. Available from: http://www.aaojournal.org/article/S0161-6420(11)00374-5/abstract

Practical Ophthalmology: A Manual for Beginning Residents, 6th Edition [Paperback]
American Academy Of Ophthalmology (Author), Fred M. Wilson II (Editor), MD (Editor)">
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		["original_publisher"] = <"openEHR Foundation">
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		["build_uid"] = <"c1c86183-529c-4d08-9904-9a14f7a2a74f">
		["ip_acknowledgements"] = <"This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomedct or info@snomed.org.">
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definition
	OBSERVATION[at0000] matches {	-- Visual acuity test result
		data matches {
			HISTORY[at0001] matches {	-- Event Series
				events cardinality matches {1..*; unordered} matches {
					EVENT[at0134] occurrences matches {0..*} matches {	-- Any event
						data matches {
							ITEM_TREE[at0003] matches {	-- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0138] occurrences matches {0..1} matches {	-- Test name
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0135, 	-- Pinhole visual acuity
													at0136, 	-- Usual corrected visual acuity
													at0137, 	-- Best corrected visual acuity
													at0139]	-- Unaided visual acuity
												}
											}
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0039] occurrences matches {0..1} matches {	-- Description
										value matches {
											DV_TEXT matches {*}
										}
									}
									CLUSTER[at0053] occurrences matches {0..2} matches {	-- Result details
										items cardinality matches {1..*; unordered} matches {
											ELEMENT[at0007] matches {	-- Eye examined
												value matches {
													DV_CODED_TEXT matches {
														defining_code matches {
															[local::
															at0012, 	-- Left eye
															at0013, 	-- Right eye
															at0014]	-- Both eyes simultaneously
														}
													}
												}
											}
											CLUSTER[at0028] occurrences matches {0..1} matches {	-- Notation
												items cardinality matches {1..*; unordered} matches {
													ELEMENT[at0056] occurrences matches {0..1} matches {	-- Metric Snellen
														value matches {
															DV_PROPORTION matches {
																numerator matches {|1.0..6.0|}
																denominator matches {|4.0..60.0|}
																is_integral matches {True}
																type matches {0}
															}
														}
													}
													ELEMENT[at0009] occurrences matches {0..1} matches {	-- US Snellen
														value matches {
															DV_PROPORTION matches {
																numerator matches {|3.0..20.0|}
																denominator matches {|2.0..200.0|}
																is_integral matches {True}
																type matches {0}
															}
														}
													}
													ELEMENT[at0057] occurrences matches {0..1} matches {	-- Decimal Snellen
														value matches {
															DV_PROPORTION matches {
																numerator matches {|0.0..2.0|}
																is_integral matches {True}
																type matches {1}
															}
														}
													}
													ELEMENT[at0011] occurrences matches {0..1} matches {	-- ETDRS Letters
														value matches {
															DV_COUNT matches {
																magnitude matches {|1..120|}
															}
														}
													}
													ELEMENT[at0046] occurrences matches {0..1} matches {	-- logMar
														value matches {
															C_DV_QUANTITY <
																property = <[openehr::380]>
																list = <
																	["1"] = <
																		units = <" ">
																		magnitude = <|-0.5..2.0|>
																		precision = <|1|>
																	>
																>
															>
														}
													}
													ELEMENT[at0015] occurrences matches {0..1} matches {	-- Low Vision Score
														value matches {
															1|[local::at0016], 	-- NPL - No perception of light
															2|[local::at0017], 	-- PL -  Perception of light
															3|[local::at0018], 	-- HM - Hand movement
															4|[local::at0019]  	-- CF - Count fingers
														}
													}
												}
											}
											ELEMENT[at0059] occurrences matches {0..1} matches {	-- Letter Termination Adjustment
												value matches {
													DV_COUNT matches {
														magnitude matches {|-10..10|; 0}
													}
												}
											}
											ELEMENT[at0010] occurrences matches {0..1} matches {	-- Derived Score
												value matches {
													DV_COUNT matches {
														magnitude matches {|>=0|}
													}
												}
											}
											ELEMENT[at0066] occurrences matches {0..*} matches {	-- Interpretation
												value matches {
													DV_TEXT matches {*}
												}
											}
											ELEMENT[at0055] occurrences matches {0..1} matches {	-- No test result
												value matches {
													DV_BOOLEAN matches {
														value matches {True}
													}
												}
											}
											ELEMENT[at0140] occurrences matches {0..1} matches {	-- Reason for no test result
												value matches {
													DV_TEXT matches {*}
												}
											}
										}
									}
									ELEMENT[at0054] occurrences matches {0..*} matches {	-- Overall Interpretation
										value matches {
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0040] occurrences matches {0..1} matches {	-- Comment
										value matches {
											DV_TEXT matches {*}
										}
									}
									allow_archetype CLUSTER[at0141] occurrences matches {0..*} matches {	-- Test not done
										include
											archetype_id/value matches {/openEHR-EHR-CLUSTER\.exclusion_exam(-[a-zA-Z0-9_]+)*\.v1/}
									}
								}
							}
						}
						state matches {
							ITEM_TREE[at0041] matches {	-- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0112] occurrences matches {0..*} matches {	-- Confounding Factors
										value matches {
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0042] occurrences matches {0..*} matches {	-- Refractive Correction
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0071, 	-- Spectacles
													at0072, 	-- Contact lenses
													at0073, 	-- Pinhole
													at0074, 	-- Autorefraction
													at0075]	-- Retinoscopy
												}
											}
										}
									}
									allow_archetype CLUSTER[at0080] occurrences matches {0..2} matches {	-- Refraction Details
										include
											archetype_id/value matches {/openEHR-EHR-CLUSTER\.refraction_details(-[a-zA-Z0-9_]+)*\.v1/}
									}
									allow_archetype CLUSTER[at0124] occurrences matches {0..1} matches {	-- Pupillary State
										include
											archetype_id/value matches {/openEHR-EHR-CLUSTER\.exam_pupils(-[a-zA-Z0-9_]+)*\.v1/}
									}
								}
							}
						}
					}
				}
			}
		}
		protocol matches {
			ITEM_TREE[at0020] matches {	-- Tree
				items cardinality matches {0..*; unordered} matches {
					ELEMENT[at0081] occurrences matches {0..1} matches {	-- Testing Distance
						value matches {
							C_DV_QUANTITY <
								property = <[openehr::122]>
								list = <
									["1"] = <
										units = <"[ft_i]">
										magnitude = <|>=0.0|>
										precision = <|1|>
									>
									["2"] = <
										units = <"m">
										magnitude = <|>=0.0|>
										precision = <|1|>
									>
									["3"] = <
										units = <"cm">
										magnitude = <|>=0.0|>
										precision = <|1|>
									>
									["4"] = <
										units = <"[in_i]">
										magnitude = <|>=0.0|>
										precision = <|1|>
									>
								>
							>
						}
					}
					ELEMENT[at0023] occurrences matches {0..1} matches {	-- Chart Method
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0082, 	-- logMar chart
									at0083, 	-- Snellen chart
									at0084, 	-- ETDRS chart
									at0109, 	-- Picture chart
									at0096, 	-- Reduced logMar
									at0097, 	-- Reduced Snellen
									at0098, 	-- Faculty of Ophthalmologists 'N' Score
									at0099]	-- Jaeger 'J' Score
								}
							}
						}
					}
					ELEMENT[at0021] occurrences matches {0..1} matches {	-- Chart Optotype
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0106, 	-- Letter
									at0107, 	-- Orientation
									at0108]	-- Picture
								}
							}
						}
					}
					ELEMENT[at0022] occurrences matches {0..1} matches {	-- Chart Scoring Algorithm
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0100, 	-- Single letter
									at0101, 	-- Whole line
									at0102]	-- Last line single letter
								}
							}
						}
					}
					allow_archetype CLUSTER[at0025] occurrences matches {0..1} matches {	-- Measurement Device Details
						include
							archetype_id/value matches {/openEHR-EHR-CLUSTER\.device(-[a-zA-Z0-9_]+)*\.v1/}
					}
					ELEMENT[at0092] occurrences matches {0..1} matches {	-- Derived Score Original Notation
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0009, 	-- US Snellen
									at0056, 	-- Metric Snellen
									at0057, 	-- Decimal Snellen
									at0011, 	-- ETDRS Letters
									at0015, 	-- Low Vision Score
									at0046]	-- logMar
								}
							}
						}
					}
					ELEMENT[at0117] occurrences matches {0..1} matches {	-- Derived Score Algorithm
						value matches {
							DV_TEXT matches {*}
						}
					}
					allow_archetype CLUSTER[at0143] occurrences matches {0..*} matches {	-- Extension
						include
							archetype_id/value matches {/.*/}
					}
				}
			}
		}
	}




ontology
	terminologies_available = <"SNOMED-CT", ...>
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"Visual acuity test result">
					description = <"Visual acuity is a measure of the spatial resolution of the visual processing system.">
				>
				["at0001"] = <
					text = <"Event Series">
					description = <"@ internal @">
				>
				["at0003"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0007"] = <
					text = <"Eye examined">
					description = <"The eye which is being examined.">
				>
				["at0009"] = <
					text = <"US Snellen">
					description = <"The distance test result, recorded as Snellen visual acuity expressed in feet, where 20/20 is regarded as normal.">
					comment = <"Examples: '20/20' , '20/40', '20/18'">
				>
				["at0010"] = <
					text = <"Derived Score">
					description = <"Visual acuity expressed as an integer score which is calculated from one or more of the other result notation formats. The original notation should be captured using 'Derived Score Original Notation' format'.">
					comment = <"Details of the algorithm used and original result format may be recorded under 'Derived Score Methodology'.">
				>
				["at0011"] = <
					text = <"ETDRS Letters">
					description = <"Visual acuity expressed using ETDRS Letters format, with a value of 100 regarded as normal.">
				>
				["at0012"] = <
					text = <"Left eye">
					description = <"The test result refers to the visual acuity of the left eye only.">
				>
				["at0013"] = <
					text = <"Right eye">
					description = <"The test result refers to the visual acuity of the right eye only.">
				>
				["at0014"] = <
					text = <"Both eyes simultaneously">
					description = <"Both eyes were examined simultaneously.">
				>
				["at0015"] = <
					text = <"Low Vision Score">
					description = <"Graded scale used when patient has low levels of visual acuity.">
				>
				["at0016"] = <
					text = <"NPL - No perception of light">
					description = <"The subject has no perception of light.">
				>
				["at0017"] = <
					text = <"PL -  Perception of light">
					description = <"The subject can perceive light.">
				>
				["at0018"] = <
					text = <"HM - Hand movement">
					description = <"The subject can perceive hand movement.">
				>
				["at0019"] = <
					text = <"CF - Count fingers">
					description = <"The subject can count fingers.">
				>
				["at0020"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0021"] = <
					text = <"Chart Optotype">
					description = <"The style of chart optotype used to assess visual acuity.">
				>
				["at0022"] = <
					text = <"Chart Scoring Algorithm">
					description = <"The alogrithm used to determine the score.">
				>
				["at0023"] = <
					text = <"Chart Method">
					description = <"The charting method used to measure visual acuity.">
				>
				["at0025"] = <
					text = <"Measurement Device Details">
					description = <"Details of the device used to measure visual acuity.">
				>
				["at0028"] = <
					text = <"Notation">
					description = <"Details of a visual acuity result recorded using one of the result notation formats.">
				>
				["at0039"] = <
					text = <"Description">
					description = <"An overall narrative description of the visual acuity test result.">
				>
				["at0040"] = <
					text = <"Comment">
					description = <"Any additional narrative comment about the visual acuity test.">
				>
				["at0041"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0042"] = <
					text = <"Refractive Correction">
					description = <"The specific type(s) of refractive correction applied when measuring visual acuity.">
					comment = <"Examples: 'No correction : unaided', 'Pinhole'.">
				>
				["at0046"] = <
					text = <"logMar">
					description = <"The test result, recorded as logMar visual acuity, where a value of 0 is regarded as normal.">
				>
				["at0053"] = <
					text = <"Result details">
					description = <"Details of the visual field test result for each eye.">
				>
				["at0054"] = <
					text = <"Overall Interpretation">
					description = <"A term, commonly coded, expressing an overall interpretation of the visual acuity test.">
				>
				["at0055"] = <
					text = <"No test result">
					description = <"No visual acuity test result is available for the test eye.">
					comment = <"Record as True if the clinician was unable to record a result for the test eye.">
				>
				["at0056"] = <
					text = <"Metric Snellen">
					description = <"The distance test result, recorded in Snellen format expressed in metres, where 6/6 is regarded as normal.">
					comment = <"Examples: '6/6, '6/12', '6/5'">
				>
				["at0057"] = <
					text = <"Decimal Snellen">
					description = <"The distance test result,recorded as Sn ellen visual acuity expressed as a decimal ratio, where 1.0 is regarded as normal.">
				>
				["at0059"] = <
					text = <"Letter Termination Adjustment">
					description = <"A line termination adjustment score applied to the visual acuity result.">
					comment = <"If the patient can read at least half of the chart line the visual acuity terminatin line is recorded as that line, with the number of letters missed on that line recorded as a negative Letter Termination Adjustment score.
If the patient can read less than half of a Visual Acuity line, the previous line is recorded as the Visual Acuity result, with the number of letters seen on the following line recorded as a positive 'Letter Termination Adjustment' score.">
				>
				["at0066"] = <
					text = <"Interpretation">
					description = <"Clinical interpretation of all results for the test eye.">
					comment = <"Example: 'Visual Acuity 20/20' or 'Jaeger 'J2' score'.">
				>
				["at0071"] = <
					text = <"Spectacles">
					description = <"The subject's vision was corrected by spectacles.">
				>
				["at0072"] = <
					text = <"Contact lenses">
					description = <"The subject's vision was corrected by contact lenses.">
				>
				["at0073"] = <
					text = <"Pinhole">
					description = <"The subject's vision was corrected by use of a pinhole.">
				>
				["at0074"] = <
					text = <"Autorefraction">
					description = <"The subject's vision was corrected by autorefraction.">
				>
				["at0075"] = <
					text = <"Retinoscopy">
					description = <"The subject's vision was corrected by retinoscopy.">
				>
				["at0080"] = <
					text = <"Refraction Details">
					description = <"Details of the refraction applied to each eye.">
				>
				["at0081"] = <
					text = <"Testing Distance">
					description = <"The distance at which the subject's visual acuity was measured.">
				>
				["at0082"] = <
					text = <"logMar chart">
					description = <"A logMar chart was used to measure distance visual acuity.">
				>
				["at0083"] = <
					text = <"Snellen chart">
					description = <"A Snellen chart was used to measure distance visual acuity.">
				>
				["at0084"] = <
					text = <"ETDRS chart">
					description = <"An ETDRS chart was used to measure distance visual acuity.">
				>
				["at0092"] = <
					text = <"Derived Score Original Notation">
					description = <"The original visual acuity result notation from which the Derived Score was calculated.">
					comment = <"When the visual acuity result is recorded using a Derived Score, this element can be used to record the original notation format, so that it can be displayed using the original notation. ">
				>
				["at0096"] = <
					text = <"Reduced logMar">
					description = <"A Reduced logMar chart was used to measure near visual acuity.">
				>
				["at0097"] = <
					text = <"Reduced Snellen">
					description = <"A Reduced Snellen chart was used to measure near visual acuity.">
				>
				["at0098"] = <
					text = <"Faculty of Ophthalmologists 'N' Score">
					description = <"Faculty of Ophthalmologists 'N' Score chart was used to measure near visual acuity.">
				>
				["at0099"] = <
					text = <"Jaeger 'J' Score">
					description = <"A Jaeger 'J' Score chart was used to measure near visual acuity.">
				>
				["at0100"] = <
					text = <"Single letter">
					description = <"A single letter algorithm was used to derive the visual acuity score.">
				>
				["at0101"] = <
					text = <"Whole line">
					description = <"A whole line algorithm was used to derive the visual acuity score.">
				>
				["at0102"] = <
					text = <"Last line single letter">
					description = <"A last line single letter algorithm was used to derive the visual acuity score.">
				>
				["at0106"] = <
					text = <"Letter">
					description = <"A letter optotype was used to measure distance visual acuity.">
				>
				["at0107"] = <
					text = <"Orientation">
					description = <"An orientation optotype was used to measure distance visual acuity.">
				>
				["at0108"] = <
					text = <"Picture">
					description = <"A picture optotype was used to measure distance visual acuity.">
				>
				["at0109"] = <
					text = <"Picture chart">
					description = <"A picture chart was used to measure distance visual acuity.">
				>
				["at0112"] = <
					text = <"Confounding Factors">
					description = <"Patient circumstances which affect interpretation of the result. Often termed 'reliability' in opthalmological documentation.">
					comment = <"Examples: 'Patient was confused', 'Low light conditions'.">
				>
				["at0117"] = <
					text = <"Derived Score Algorithm">
					description = <"Details of the algorithm used to calculate a derived score.">
				>
				["at0124"] = <
					text = <"Pupillary State">
					description = <"Details of the state of the pupil on examination.">
				>
				["at0134"] = <
					text = <"Any event">
					description = <"Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.">
				>
				["at0135"] = <
					text = <"Pinhole visual acuity">
					description = <"The test is performed with pinhole refraction applied.">
				>
				["at0136"] = <
					text = <"Usual corrected visual acuity">
					description = <"The test is performed with the patient's usual refractive correction i.e spectacles or contact lenses.">
				>
				["at0137"] = <
					text = <"Best corrected visual acuity">
					description = <"The test is performed with the patient's optimal refractive correction.">
				>
				["at0138"] = <
					text = <"Test name">
					description = <"The name of the exact visual acuity test performed. This generally represents a broad category of applied refraction. Specific refraction details can be described using 'Refractive Correction'.">
					comment = <"Details of the exact correction applied, or where multiple corrections should be captured via 'Refractive Correction'.">
				>
				["at0139"] = <
					text = <"Unaided visual acuity">
					description = <"The test was performed without visual aid.">
				>
				["at0140"] = <
					text = <"Reason for no test result">
					description = <"Reason why no visual acuity test result is available for the test eye.">
					comment = <"For example, patient was not cooperative; patient was not capable; ran out of time.">
				>
				["at0141"] = <
					text = <"Test not done">
					description = <"Details to explicitly record that this test was not performed.">
				>
				["at0143"] = <
					text = <"Extension">
					description = <"Additional information required to capture local content or to align with other reference models/formalisms.">
					comment = <"For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents.">
				>
			>
		>
		["es-cl"] = <
			items = <
				["at0000"] = <
					text = <"*Visual acuity test result(en)">
					description = <"*Visual acuity is a measure of the spatial resolution of the visual processing system.(en)">
				>
				["at0001"] = <
					text = <"Event Series">
					description = <"@ internal @">
				>
				["at0003"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0007"] = <
					text = <"*Eye examined(en)">
					description = <"*The eye which is being examined.(en)">
				>
				["at0009"] = <
					text = <"*US Snellen(en)">
					description = <"*The distance test result, recorded as Snellen visual acuity expressed in feet, where 20/20 is regarded as normal.(en)">
					comment = <"*Examples: '20/20' , '20/40', '20/18'(en)">
				>
				["at0010"] = <
					text = <"*Derived Score(en)">
					description = <"*Visual acuity expressed as an integer score which is calculated from one or more of the other result notation formats. The original notation should be captured using 'Derived Score Original Notation' format'.(en)">
					comment = <"*Details of the algorithm used and original result format may be recorded under 'Derived Score Methodology'.(en)">
				>
				["at0011"] = <
					text = <"*ETDRS Letters(en)">
					description = <"*Visual acuity expressed using ETDRS Letters format, with a value of 100 regarded as normal.(en)">
				>
				["at0012"] = <
					text = <"*Left eye(en)">
					description = <"*The test result refers to the visual acuity of the left eye only.(en)">
				>
				["at0013"] = <
					text = <"*Right eye(en)">
					description = <"*The test result refers to the visual acuity of the right eye only.(en)">
				>
				["at0014"] = <
					text = <"*Both eyes simultaneously(en)">
					description = <"*Both eyes were examined simultaneously.(en)">
				>
				["at0015"] = <
					text = <"*Low Vision Score(en)">
					description = <"*Graded scale used when patient has low levels of visual acuity.(en)">
				>
				["at0016"] = <
					text = <"*NPL - No perception of light(en)">
					description = <"*The subject has no perception of light.(en)">
				>
				["at0017"] = <
					text = <"*PL -  Perception of light(en)">
					description = <"*The subject can perceive light.(en)">
				>
				["at0018"] = <
					text = <"*HM - Hand movement(en)">
					description = <"*The subject can perceive hand movement.(en)">
				>
				["at0019"] = <
					text = <"*CF - Count fingers(en)">
					description = <"*The subject can count fingers.(en)">
				>
				["at0020"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0021"] = <
					text = <"*Chart Optotype(en)">
					description = <"*The style of chart optotype used to assess visual acuity.(en)">
				>
				["at0022"] = <
					text = <"*Chart Scoring Algorithm(en)">
					description = <"*The alogrithm used to determine the score.(en)">
				>
				["at0023"] = <
					text = <"*Chart Method(en)">
					description = <"*The charting method used to measure visual acuity.(en)">
				>
				["at0025"] = <
					text = <"*Measurement Device Details(en)">
					description = <"*Details of the device used to measure visual acuity.(en)">
				>
				["at0028"] = <
					text = <"*Notation(en)">
					description = <"*Details of a visual acuity result recorded using one of the result notation formats.(en)">
				>
				["at0039"] = <
					text = <"*Description(en)">
					description = <"*An overall narrative description of the visual acuity test result.(en)">
				>
				["at0040"] = <
					text = <"*Comment(en)">
					description = <"*Any additional narrative comment about the visual acuity test.(en)">
				>
				["at0041"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0042"] = <
					text = <"*Refractive Correction(en)">
					description = <"*The specific type(s) of refractive correction applied when measuring visual acuity.(en)">
					comment = <"*Examples: 'No correction : unaided', 'Pinhole'.(en)">
				>
				["at0046"] = <
					text = <"*logMar(en)">
					description = <"*The test result, recorded as logMar visual acuity, where a value of 0 is regarded as normal.(en)">
				>
				["at0053"] = <
					text = <"*Result details(en)">
					description = <"*Details of the visual field test result for each eye.(en)">
				>
				["at0054"] = <
					text = <"*Overall Interpretation(en)">
					description = <"*A term, commonly coded, expressing an overall interpretation of the visual acuity test.(en)">
				>
				["at0055"] = <
					text = <"*No test result(en)">
					description = <"*No visual acuity test result is available for the test eye.(en)">
					comment = <"*Record as True if the clinician was unable to record a result for the test eye.(en)">
				>
				["at0056"] = <
					text = <"*Metric Snellen(en)">
					description = <"*The distance test result, recorded in Snellen format expressed in metres, where 6/6 is regarded as normal.(en)">
					comment = <"*Examples: '6/6, '6/12', '6/5'(en)">
				>
				["at0057"] = <
					text = <"*Decimal Snellen(en)">
					description = <"*The distance test result,recorded as Sn ellen visual acuity expressed as a decimal ratio, where 1.0 is regarded as normal.(en)">
				>
				["at0059"] = <
					text = <"*Letter Termination Adjustment(en)">
					description = <"*A line termination adjustment score applied to the visual acuity result.(en)">
					comment = <"*If the patient can read at least half of the chart line the visual acuity terminatin line is recorded as that line, with the number of letters missed on that line recorded as a negative Letter Termination Adjustment score.
If the patient can read less than half of a Visual Acuity line, the previous line is recorded as the Visual Acuity result, with the number of letters seen on the following line recorded as a positive 'Letter Termination Adjustment' score.(en)">
				>
				["at0066"] = <
					text = <"*Interpretation(en)">
					description = <"*Clinical interpretation of all results for the test eye.(en)">
					comment = <"*Example: 'Visual Acuity 20/20' or 'Jaeger 'J2' score'.(en)">
				>
				["at0071"] = <
					text = <"*Spectacles(en)">
					description = <"*The subject's vision was corrected by spectacles.(en)">
				>
				["at0072"] = <
					text = <"*Contact lenses(en)">
					description = <"*The subject's vision was corrected by contact lenses.(en)">
				>
				["at0073"] = <
					text = <"*Pinhole(en)">
					description = <"*The subject's vision was corrected by use of a pinhole.(en)">
				>
				["at0074"] = <
					text = <"*Autorefraction(en)">
					description = <"*The subject's vision was corrected by autorefraction.(en)">
				>
				["at0075"] = <
					text = <"*Retinoscopy(en)">
					description = <"*The subject's vision was corrected by retinoscopy.(en)">
				>
				["at0080"] = <
					text = <"*Refraction Details(en)">
					description = <"*Details of the refraction applied to each eye.(en)">
				>
				["at0081"] = <
					text = <"*Testing Distance(en)">
					description = <"*The distance at which the subject's visual acuity was measured.(en)">
				>
				["at0082"] = <
					text = <"*logMar chart(en)">
					description = <"*A logMar chart was used to measure distance visual acuity.(en)">
				>
				["at0083"] = <
					text = <"*Snellen chart(en)">
					description = <"*A Snellen chart was used to measure distance visual acuity.(en)">
				>
				["at0084"] = <
					text = <"*ETDRS chart(en)">
					description = <"*An ETDRS chart was used to measure distance visual acuity.(en)">
				>
				["at0092"] = <
					text = <"*Derived Score Original Notation(en)">
					description = <"*The original visual acuity result notation from which the Derived Score was calculated.(en)">
					comment = <"*When the visual acuity result is recorded using a Derived Score, this element can be used to record the original notation format, so that it can be displayed using the original notation. (en)">
				>
				["at0096"] = <
					text = <"*Reduced logMar(en)">
					description = <"*A Reduced logMar chart was used to measure near visual acuity.(en)">
				>
				["at0097"] = <
					text = <"*Reduced Snellen(en)">
					description = <"*A Reduced Snellen chart was used to measure near visual acuity.(en)">
				>
				["at0098"] = <
					text = <"*Faculty of Ophthalmologists 'N' Score(en)">
					description = <"*Faculty of Ophthalmologists 'N' Score chart was used to measure near visual acuity.(en)">
				>
				["at0099"] = <
					text = <"*Jaeger 'J' Score(en)">
					description = <"*A Jaeger 'J' Score chart was used to measure near visual acuity.(en)">
				>
				["at0100"] = <
					text = <"*Single letter(en)">
					description = <"*A single letter algorithm was used to derive the visual acuity score.(en)">
				>
				["at0101"] = <
					text = <"*Whole line(en)">
					description = <"*A whole line algorithm was used to derive the visual acuity score.(en)">
				>
				["at0102"] = <
					text = <"*Last line single letter(en)">
					description = <"*A last line single letter algorithm was used to derive the visual acuity score.(en)">
				>
				["at0106"] = <
					text = <"*Letter(en)">
					description = <"*A letter optotype was used to measure distance visual acuity.(en)">
				>
				["at0107"] = <
					text = <"*Orientation(en)">
					description = <"*An orientation optotype was used to measure distance visual acuity.(en)">
				>
				["at0108"] = <
					text = <"*Picture(en)">
					description = <"*A picture optotype was used to measure distance visual acuity.(en)">
				>
				["at0109"] = <
					text = <"*Picture chart(en)">
					description = <"*A picture chart was used to measure distance visual acuity.(en)">
				>
				["at0112"] = <
					text = <"*Confounding Factors(en)">
					description = <"*Patient circumstances which affect interpretation of the result. Often termed 'reliability' in opthalmological documentation.(en)">
					comment = <"*Examples: 'Patient was confused', 'Low light conditions'.(en)">
				>
				["at0117"] = <
					text = <"*Derived Score Algorithm(en)">
					description = <"*Details of the algorithm used to calculate a derived score.(en)">
				>
				["at0124"] = <
					text = <"*Pupillary State(en)">
					description = <"*Details of the state of the pupil on examination.(en)">
				>
				["at0134"] = <
					text = <"*Any event(en)">
					description = <"*Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.(en)">
				>
				["at0135"] = <
					text = <"*Pinhole visual acuity(en)">
					description = <"*The test is performed with pinhole refraction applied.(en)">
				>
				["at0136"] = <
					text = <"*Usual corrected visual acuity(en)">
					description = <"*The test is performed with the patient's usual refractive correction i.e spectacles or contact lenses.(en)">
				>
				["at0137"] = <
					text = <"*Best corrected visual acuity(en)">
					description = <"*The test is performed with the patient's optimal refractive correction.(en)">
				>
				["at0138"] = <
					text = <"*Test name(en)">
					description = <"*The name of the exact visual acuity test performed. This generally represents a broad category of applied refraction. Specific refraction details can be described using 'Refractive Correction'.(en)">
					comment = <"*Details of the exact correction applied, or where multiple corrections should be captured via 'Refractive Correction'.(en)">
				>
				["at0139"] = <
					text = <"*Unaided visual acuity(en)">
					description = <"*The test was performed without visual aid.(en)">
				>
				["at0140"] = <
					text = <"*Reason for no test result(en)">
					description = <"*Reason why no visual acuity test result is available for the test eye.(en)">
					comment = <"*For example, patient was not cooperative; patient was not capable; ran out of time.(en)">
				>
				["at0141"] = <
					text = <"*Test not done(en)">
					description = <"*Details to explicitly record that this test was not performed.(en)">
				>
				["at0143"] = <
					text = <"*Extension(en)">
					description = <"*Additional information required to capture local content or to align with other reference models/formalisms.(en)">
					comment = <"*For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents.(en)">
				>
			>
		>
		["nb"] = <
			items = <
				["at0000"] = <
					text = <"Skarpsyn (visus)">
					description = <"Skarpsyn (visus) er målingen">
				>
				["at0001"] = <
					text = <"Event Series">
					description = <"@ internal @">
				>
				["at0003"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0007"] = <
					text = <"Øye undersøkt">
					description = <"Det øyet som ble undersøkt.">
				>
				["at0009"] = <
					text = <"US Snellen">
					description = <"Registrert i US Snellen format uttrykt i fot, hvor 20/20 er normalt.">
					comment = <"Eksempler: '20/20' , '20/40', '20/18'">
				>
				["at0010"] = <
					text = <"Derivert Visus">
					description = <"Visus omregnet fra en formatene under \"Resultat\". Det originale resultatet skal registreres i sitt tilhørende felt.">
					comment = <"Detaljer rundt originale algoritmen og format av resultat kan registreres under \"Derivert Visus-metode\"">
				>
				["at0011"] = <
					text = <"ETDRS Bokstaver">
					description = <"Registrert i EDTRS bokstav-format uttrykt i heltallsverdi hvor 100 er normalt.">
				>
				["at0012"] = <
					text = <"Venstre øye">
					description = <"Visus målt kun med venstre øye.">
				>
				["at0013"] = <
					text = <"Høyre øye.">
					description = <"Visus målt kun med høyre øye.">
				>
				["at0014"] = <
					text = <"Begge øyne">
					description = <"Visus målt med begge øyne.">
				>
				["at0015"] = <
					text = <"Svaksynsmåling">
					description = <"Nivåer av svaksyn registrert som strukturerte valg.">
				>
				["at0016"] = <
					text = <"Ikke lyssans">
					description = <"Pasienten angir ingen lyssans.">
				>
				["at0017"] = <
					text = <"Lyssans">
					description = <"Pasienten angir lyssans.">
				>
				["at0018"] = <
					text = <"Håndbevegelse">
					description = <"Pasienten ser håndbevegelser.">
				>
				["at0019"] = <
					text = <"Fingertelling">
					description = <"Pasienten klarer å telle fingre.">
				>
				["at0020"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0021"] = <
					text = <"Tavlens optotype">
					description = <"Tavlens optotype som ble brukt for å måle visus.">
				>
				["at0022"] = <
					text = <"Tavlens testalgoritme">
					description = <"Tavlens testalgoritme.">
				>
				["at0023"] = <
					text = <"Tavlemetode">
					description = <"Type visustavle som ble benyttet.">
				>
				["at0025"] = <
					text = <"Målingsenhetdetaljer">
					description = <"Registrering av detaljer om målingsenhet.">
				>
				["at0028"] = <
					text = <"Resultat">
					description = <"Registrering av resultatet av visusmåling i en eller flere av de formatene som støttes.">
				>
				["at0039"] = <
					text = <"Beskrivelse">
					description = <"Overordnet beskrivelse av visusmåling.">
				>
				["at0040"] = <
					text = <"Kommentar.">
					description = <"Kommentarer til visusmålingen.">
				>
				["at0041"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0042"] = <
					text = <"Refraktiv korreksjon">
					description = <"Type refraksjon som ble benyttet under visusmålingen.">
					comment = <"Eksempler: \"Ingen korreksjon\", \"Stenopeisk hull\".">
				>
				["at0046"] = <
					text = <"logMar">
					description = <"Registrert i logMar-format uttrykt, hvor 0 er normalt.">
				>
				["at0053"] = <
					text = <"Pr. øye">
					description = <"Detaljert resultat for hvert eller begge øyne.">
				>
				["at0054"] = <
					text = <"Overordnet tolkning">
					description = <"Resultat av en overordnet tolkning av visus, normalt angitt som en strukturert angivelse av visus.">
				>
				["at0055"] = <
					text = <"Ikke utført">
					description = <"Detaljer av visusmåling som ikke ble gjennomført.">
					comment = <"Detaljer rundt årsakt til manglende gjennomføring av visusmåling.">
				>
				["at0056"] = <
					text = <"Metrisk Snellen">
					description = <"Registrert i Snellen format uttrykt i meter, hvor 6/6 er normalt.">
					comment = <"Eksempler: '6/6, '6/12', '6/5'">
				>
				["at0057"] = <
					text = <"Desimal Snellen">
					description = <"Registrert i US Snellen format uttrykt som desimaltall hvor 1,0 er normalt.">
				>
				["at0059"] = <
					text = <"Justering av bokstaver">
					description = <"Justering av antall bokstaver lest på synstavlen.">
					comment = <"Hvis pasienten ser minst halvparten av bokstavene på en linje regnes denne som gjeldende visus, antall bokstaver som ikke sees på denne linjen registreres som negative i \"Justering av bokstaver\".
Hvis pasienten ser under halvparten av bokstavene på en linje regnes denne ikke som gjeldende visus, men antall bokstaver sett på denne linjen registreres som positive i \"Justering av bokstaver\".">
				>
				["at0066"] = <
					text = <"Tolkning">
					description = <"Visus uttrykt i kvalitativ form, oftest strukturert.">
					comment = <"Eksempel: 'Visus 20/20' eller 'Jaeger 'J2''.">
				>
				["at0071"] = <
					text = <"Briller">
					description = <"Visus korrigert med briller.">
				>
				["at0072"] = <
					text = <"Kontaktlinser">
					description = <"Visus korrigert med kontaktlinser.">
				>
				["at0073"] = <
					text = <"Stenopeisk hull.">
					description = <"Visus korrigert med stenopeisk hull.">
				>
				["at0074"] = <
					text = <"Autorefraktor">
					description = <"Visuskorreksjon gjort med autorefraktor.">
				>
				["at0075"] = <
					text = <"Retinoskopi">
					description = <"Visuskorreksjon gjort med retinoskopi.">
				>
				["at0080"] = <
					text = <"Refraksjoneringsdetaljer.">
					description = <"Detaljert beskrivelse av refraksjonen for hvert øye.">
				>
				["at0081"] = <
					text = <"Testavstand">
					description = <"Avstanden som visus ble testet på.">
				>
				["at0082"] = <
					text = <"logMar">
					description = <"En logMar-tvale ble benyttet.">
				>
				["at0083"] = <
					text = <"Snellen">
					description = <"En Snellentavle ble benyttet.">
				>
				["at0084"] = <
					text = <"ETDRS">
					description = <"En ETDRS-tvale ble benyttet.">
				>
				["at0092"] = <
					text = <"Utgangspunkt for kalkulert visus">
					description = <"Hvilke type notering av visus som er utgangspuktet kalkulert visus.">
					comment = <"Om visus registreres i \"Derivert visus\", skal dette feltet benyttes for å registrere hva utgangspunktet for den kalkulerte \"Derivert visus\" var.">
				>
				["at0096"] = <
					text = <"Redusert logMar">
					description = <"En redusert logMar-tavle ble benyttet for måling av nærvisus.">
				>
				["at0097"] = <
					text = <"Redusert Snellen">
					description = <"En redusert Snellen-tavle ble benyttet for måling av nærvisus.">
				>
				["at0098"] = <
					text = <"Fakultetet av Oftalmologers 'N'">
					description = <"Fakultetet av Oftalmologers 'N'-tavle ble beyttet til måling av nærvisus.">
				>
				["at0099"] = <
					text = <"Jaeger 'J'">
					description = <"En Jaeger 'J'-tavle ble benyttet til måling av nærvisus.">
				>
				["at0100"] = <
					text = <"En bokstav">
					description = <"\"En bokstavs\"-algoritme ble benyttet.">
				>
				["at0101"] = <
					text = <"Hele linjer">
					description = <"\"Hele linjer\"-algoritme ble benyttet.">
				>
				["at0102"] = <
					text = <"Siste enkeltbokstav">
					description = <"\"Siste enkeltbokstav\"-algoritme benyttet.">
				>
				["at0106"] = <
					text = <"Bokstaver">
					description = <"Bokstaver ble benyttet til å teste avstandsvisus.">
				>
				["at0107"] = <
					text = <"Orientering av figur">
					description = <"Orientering av en figur ble benyttet til måling av avstandsvisus.">
				>
				["at0108"] = <
					text = <"Bilde">
					description = <"Bilder ble benyttet til måling av avstandsvisus.">
				>
				["at0109"] = <
					text = <"Bildetavle">
					description = <"En bildetavle ble benyttet.">
				>
				["at0112"] = <
					text = <"Konfunderene faktorer.">
					description = <"Omstendigheter som kan påvirke resultatet.">
					comment = <"Eksempler: \"Pasienten var forvirret\", \"Dårlige lysforhold\".">
				>
				["at0117"] = <
					text = <"Kalkuleringsalgoritme">
					description = <"Kalkuleringsalgoritme for omregning av visus til \"Derivert visus\"">
				>
				["at0124"] = <
					text = <"Pupillestatus">
					description = <"Detaljert beskrivelse av pupillestatus.">
				>
				["at0134"] = <
					text = <"Uspesifisert hendelse">
					description = <"Uspesifiserte hendelser.">
				>
				["at0135"] = <
					text = <"Stenopeisk hull">
					description = <"Test utført med stenopeisk hull.">
				>
				["at0136"] = <
					text = <"Korreksjon med pasientes normale refraksjon">
					description = <"Korreksjon utført med pasientes normale refraksjon, som oftest pasientens egne briller, linser eller refraksjonen fra pasientens egne briller/linser i foroptoer.">
				>
				["at0137"] = <
					text = <"Beste korrigerte visus">
					description = <"Testen benytter refraksjon som gir best visus.">
				>
				["at0138"] = <
					text = <"Visustype">
					description = <"Angivelsen av type visus som er målt. Dette er den generelle beskrivelsen av type refraksjon som er benyttet. Spesific refraksjon kan registreres i eget cluster under \"Refraktiv korreksjon\" eller \"Andre detaljer\", avhengig av hvor det e rmest hensiktsmessig å plassere refraksjonen.">
					comment = <"Detaljer rundt eksakt korreksjon som ble benyttet. Ved multiple korreksjoner bør dette registrers i flere clustere med refraksjonsdetaljer, da bør disse ligge inn under \"Resultat\"-clusteret for å knyttes til sin respektive visus.">
				>
				["at0139"] = <
					text = <"Ukorrigert visus">
					description = <"Testen er utført uten refraksjon.">
				>
				["at0140"] = <
					text = <"Anatomisk lokalisasjon">
					description = <"Anatomisk lokalisasjon som beskriver hvilke øye eller begge øyne som visus gjelder.">
					comment = <"For eksempel: dårlig samarbeid, ikke i stand til å gjennomføre, ikke tid til å gjennomføre.">
				>
				["at0141"] = <
					text = <"Andre detaljer">
					description = <"Andre detaljer, som f.eks. cluster for registrering av benyttet refraksjon.">
				>
				["at0143"] = <
					text = <"Digital foropter">
					description = <"Benyttet digital foropter.">
					comment = <"For eksempel: lokale informasjonskrav eller ekstra metadata for å tilpasse seg FHIR eller CIMI.">
				>
			>
		>
	>
	term_bindings = <
		["SNOMED-CT"] = <
			items = <
				["at0009"] = <[SNOMED-CT::422673001]>
				["at0012"] = <[SNOMED-CT::362503005]>
				["at0013"] = <[SNOMED-CT::362502000]>
				["at0019"] = <[SNOMED-CT::422256009]>
				["at0039"] = <[SNOMED-CT::117364006]>
				["at0040"] = <[SNOMED-CT::117364006]>
				["at0054"] = <[SNOMED-CT::271922009]>
				["at0056"] = <[SNOMED-CT::422673001]>
				["at0057"] = <[SNOMED-CT::422673001]>
				["at0066"] = <[SNOMED-CT::363983007]>
				["at0071"] = <[SNOMED-CT::50121007]>
				["at0072"] = <[SNOMED-CT::57368009]>
				["at0075"] = <[SNOMED-CT::397524001]>
				["at0081"] = <[SNOMED-CT::252124009]>
				["at0083"] = <[SNOMED-CT::400913005]>
				["at0084"] = <[SNOMED-CT::400914004]>
				["at0097"] = <[SNOMED-CT::422673001]>
			>
		>
	>