Farnsworth Lantern Test
The purpose of the Farnsworth Lantern Test is to evaluate color perception. The Farnsworth Lantern is a machine with a light source directed at the examinee. What the examinee sees is two lights in a vertical plane. These lights appear in two of three possible colors, either red, green, or white, shown in varying combinations. The examinee is asked to identify the color combinations from top to bottom at a distance of 8 feet; the examiner rotates the drum to provide the different combinations. The examinee must identify a total of nine different combinations.

On the first run of nine lights, if the examinee correctly identifies all nine, the FALANT is passed. If the examinee incorrectly identifies any of the lights, two additional runs of nine lights are performed without interruption. The score is the average number of incorrectly identified lights of the second two runs. If the average score is 1 or less, the FALANTis passed. If the score is 2 or more, the FALANT is failed. If the score is 1.5, the test should be repeated after a 5-minute break. Do not retest scores of 2 or more since this will invalidate the test procedure.

NOTE: If examinees wear corrective lenses for distant vision, they should wear them during this test.

Pseudoisochromatic Plates
If the FALANT is not available, pseudoiso-chromatic plates (PIP) are used to determine color vision. Personnel so tested must be retested with the FALANT at the first activity they report to that has a Farnsworth Lantern. Two tests are available, the 18-plate test and the 15-plate test, each of which includes one demonstration plate not used for scoring.

When administering the PIP examination, you should hold the plates 30 inches from the examinee. Allow 2 seconds for each plate identification, and do not allow the examinee to touch the plates. To pass the 18-plate test, the examinee must identify a minimum of 14 of the 17 test plates; for the 15-plate test, a minimum of 10 of the 14 test plates. Record the score in block 64 of the SF 88 as PASSED PIP or FAILED PIP. Include the number of correct responses (e.g., PASSED PIP 17 of 17 or FAILED PIP 10 of 17).

AUDIOGRAM
An audiogram is a record of hearing thresholds an individual has for various sound frequencies. By evaluating an individual's frequency thresholds, hearing deficiencies can be detected. To test an individual's frequency thresholds, the technician will use an instrument called an audiometer (manual or computerized). Audiometers used by the Navy are calibrated to American National Standards Institute (ANSI) specifications.

Upon entry into the service, a baseline audiogram is performed and recorded on a DD 2215. Subsequent audiometric test results are recorded on a DD2216 and performed as directed by OPNAVINST 5100.19 and the MANMED. Audiometric testing shall be performed only by personnel who have attended an audiometric training course and have been certified. All audiometric tracings or readings recorded on the SF 88 or other medical documentation should contain the certification number of the person performing the audiometric test.

ELECTROCARDIOGRAM
An electrocardiogram is a record of electrical impulses made by the heart. Electrocardiograms are produced by an instrument called an electrocardiograph. The electrocardiograph is used to examine and record electrical impulses produced by the contraction of the heart muscle. Abbreviated either EKG or ECG, the electrocardiogram is interpreted by a physician or cardiologist to determine the heart rate and rhythm, and evidence of any heart damage, especially damage associated with a heart attack.

EKGs are currently performed as part of the physical examination once the member reaches the age of 40, and routinely thereafter. Otherwise, EKGs are performed only as clinically indicated or required for special duty. Refer to BUMEDinstructions for current periodicity information on EKG testing. The Naval Medical Department routinely uses EKGs with 12 leads for physical examinations performed on Navy and Marine Corps personnel.

SUMMARY
A general review has been provided to you on various types of physical examinations, their requirements, and the documentation procedures of commonly used physical examination forms. We have also discussed physical examination testing equipment and procedures that evaluate vision, hearing, and cardiac function.

The physical examination is a key component of the Navy Medical Department's efforts to maintain the health of Sailors and Marines during times of war and peace. The importance of the physical examination cannot be overstated. The combination of medical history, medical testing, and medical examination furnishes the healthcare provider with a complete picture of the individual's health. Any indications of medical problems can be evaluated and managed more expediently and effectively through the use of the physical examination. Your assistance with medical testing and your detailed document management will ensure the patient receives the best possible medical evaluation by the medical examiner. More in-depth information is contained in the Manual of the Medical Department, NAVMED P-117.