Certified Ophthalmic Technician (COT) Practice Test 2025 - Free COT Practice Questions and Study Guide

When a patient's visual acuity is measured at 20/70 with correction, it indicates that their best-corrected vision is still not within the normal range of 20/20 and suggests that there may be an issue with their current distance prescription. However, when the pinhole test is applied, and the vision improves to 20/25, this suggests that the visual system is capable of much better clarity, which is typically achieved when refractive errors, such as myopia, hyperopia, or astigmatism, are corrected.

The significant improvement with the pinhole indicates that the visual acuity loss at distance is likely due to a refractive error rather than non-refractive factors like amblyopia or structural issues such as corneal problems. Amblyopia would typically present as a persistent reduction in vision with or without correction and would not usually show significant improvement with the pinhole test. Similarly, corneal issues would likely lead to consistently reduced visual acuity that does not improve significantly with correction or through a pinhole.

Therefore, the most direct implication of this scenario is that the patient requires an improved or more precise distance correction to maximize their visual acuity.