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Farassat N, Jehle V, Heinrich SP, Lagrèze WA, Bach M. The Freiburg Acuity Test in Preschool Children: Testability, Test-Retest Variability, and Comparison With LEA Symbols. Transl Vis Sci Technol 2024; 13:14. [PMID: 38502142 PMCID: PMC10959192 DOI: 10.1167/tvst.13.3.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/24/2024] [Indexed: 03/20/2024] Open
Abstract
Purpose To determine the testability, performance, and test-retest variability (TRV) of visual acuity (VA) assessment using the Freiburg Visual Acuity Test (FrACT) compared to the LEA Symbols Test (LEA) in preschool children. Methods In 134 preschool children aged 3.0 to 6.8 years, monocular VA of each eye was measured twice with a four-orientation Landolt C version of the FrACT and once with the LEA. FrACT runs were preceded by a binocular run for explanatory purposes. Test order alternated between subjects. Optotypes were presented on a computer monitor (FrACT) or on cards (LEA) at a distance of 3 m. Results Overall, 68% completed the FrACT (91/134 children) and 88% completed the LEA (118/134 children). Testability depended on age: FrACT, 19% (<4 years) and 87% (≥4 years); LEA, 70% (<4 years) and 95% (≥4 years). Mean ± SD VA difference between tests was 0.11 ± 0.19 logarithm of the minimum angle of resolution [logMAR], with LEA reporting better acuity. The difference depended on age (0.27 ± 0.23 logMAR [<4 years], 0.09 ± 0.18 logMAR [≥4 years], P < 0.001) and on test sequence (higher age dependence of FrACT VAs for LEA first, P < 0.001). The 95% limits of agreement for the FrACT TRV were ±0.298 logMAR. Conclusions The examiner-independent FrACT, using international reference Landolt C optotypes, can be used to assess VA in preschool children aged ≥4 years, with reliability comparable to other pediatric VA tests. Translational Relevance Use of the automated FrACT for VA assessment in preschool children may benefit objectivity and validity as it is a computerized test and employs the international reference Landolt C optotype.
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Affiliation(s)
- Navid Farassat
- Eye Center, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Vanessa Jehle
- Eye Center, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sven P. Heinrich
- Eye Center, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Wolf A. Lagrèze
- Eye Center, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Bach
- Eye Center, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Opoku-Yamoah V, Christian LW, Irving EL, Jones D, McCulloch D, Rose K, Leat SJ. Validation of the Waterloo Differential Visual Acuity Test (WatDAT) and Comparison With Existing Pediatric Tests of Visual Acuity. Transl Vis Sci Technol 2023; 12:13. [PMID: 37733350 PMCID: PMC10517421 DOI: 10.1167/tvst.12.9.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Purpose The new Waterloo Differential Acuity Test (WatDAT) is designed to allow recognition visual acuity (VA) measurement in children before they can typically undertake matching tests. The study purpose was to validate WatDAT in adults with normal and reduced VA. Methods Eighty adults (18 to <40 years of age) participated (32 normal VA, 12 reduced VA, and 36 simulated reduced VA). Monocular VA was measured on two occasions in random order for WatDAT (versions with 3 and 5 distractors for Faces and Patti Pics house among circles), Lea Symbols, Kay Pictures and Patti Pics matching tests, Teller Acuity Cards, Cardiff Acuity Test, and Early Treatment Diabetic Retinopathy Study (ETDRS) letter chart. Pediatric tests were validated against ETDRS using limits of agreement (LoA), sensitivity, and specificity. The LoA for repeatability were also determined. Results WatDAT showed minimal bias compared with ETDRS, and LoAs, which were similar to pediatric matching tests (0.241-0.250). Both preferential looking tests showed higher bias and LoAs than ETDRS. Matching tests showed good agreement with ETDRS, except for Kay Pictures and Lea Uncrowded test, which overestimated VA. WatDAT showed high sensitivity (>0.96) and specificity (>0.79), which improved with criterion adjustment and were significantly higher than for the preferential looking tests. LoA for repeatability for WatDAT 3 Faces and WatDAT 5 Faces were comparable with the ETDRS. Conclusions WatDAT demonstrates good agreement and repeatability compared with the gold-standard ETDRS letter chart, and performed better than preferential looking tests, the alternative until a child can undertake a matching VA test. Translational Relevance Good validity of the Waterloo Differential Acuity Test was demonstrated in adults as a first step to showing its potential for detecting childhood visual disorders.
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Affiliation(s)
- Victor Opoku-Yamoah
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Lisa W. Christian
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Elizabeth L. Irving
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Deborah Jones
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Daphne McCulloch
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Kalpana Rose
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Susan J. Leat
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
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Hussaindeen JR, Ramakrishnan B, Ravi A, SundarRaj M, Rakshit A, Nosofsky RM, Candy TR. Discrimination of paediatric acuity test optotypes by 6-year-old children. Ophthalmic Physiol Opt 2023; 43:964-971. [PMID: 37272135 PMCID: PMC10524911 DOI: 10.1111/opo.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE To compare the discrimination performance of 6-year-old children for optotypes from six paediatric visual acuity tests and to fit Luce's Biased Choice Model to the data to estimate the relative similarities and bias for each optotype. METHODS Full data sets were collected from 20 typically developing 6-year-olds who had passed a vision screening. They were presented with single optotypes labelled 6/12 at a distance of 9 m and were asked to identify the optotype using a matching task containing all optotypes from the relevant test. The data were combined to form a confusion matrix for each test and a biased choice model was fitted to the data. RESULTS Median correct performance varied from 40% to 100% across optotypes, with the HOTV test having the highest values. Estimates of the similarity of each pair of optotypes indicated equal values for all pairs in the Landolt C, HOTV, Lea numbers and Tumbling E tests. The values differed for the picture tests, that is Lea Symbols and Allen figures. The estimates of bias for each individual optotype also indicated different values with the picture tests. CONCLUSIONS Previous studies of the threshold acuity of young children and adults have indicated differences in acuity estimates across paediatric tests. A recognition acuity task typically requires resolving the difference information between optotypes. The performance of the 6-year-olds here reveals variance in similarity and bias values for picture tests, particularly for the Allen figures when compared with the Lea Symbols. Ideally, this analysis should be performed when designing new tests, and these results motivate progression from the use of current picture tests to well calibrated letter or number tests at the earliest possible age.
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Affiliation(s)
- Jameel Rizwana Hussaindeen
- Elite School of Optometry, Units of Medical Research Foundation, Chennai, India
- Sankara Nethralaya, Units of Medical Research Foundation, Chennai, India
| | | | - Aishwarya Ravi
- Sankara Nethralaya, Units of Medical Research Foundation, Chennai, India
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Monisha SundarRaj
- Sankara Nethralaya, Units of Medical Research Foundation, Chennai, India
| | - Archayeeta Rakshit
- Elite School of Optometry, Units of Medical Research Foundation, Chennai, India
- Sankara Nethralaya, Units of Medical Research Foundation, Chennai, India
| | - Robert M Nosofsky
- Psychological & Brain Sciences, Indiana University, Bloomington, Indiana, USA
| | - T Rowan Candy
- School of Optometry, Indiana University, Bloomington, Indiana, USA
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Sapkota A, Sitaula S, Shrestha GS, Joshi ND, Koirala B, Paudel N. Agreement between Lea Symbols and Patti Pics visual acuity in children and adults. JOURNAL OF OPTOMETRY 2023:S1888-4296(23)00003-1. [PMID: 36717317 DOI: 10.1016/j.optom.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/25/2022] [Accepted: 01/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Patti Pics (PP) and Lea Symbols (LS) are commonly used by eye care practitioners worldwide. Although the relationship between the two tests is fairly well understood, the availability of different chart designs (single optotypes, multiple optotypes, multiple optotypes with crowding box) merits futher understanding. The purpose of this study is to explore the agreement between the acuity measures obtained with Patti Pics and Lea Symbols in children and adults and compare their performance with the Sloan Letter (SL) chart in adults. METHODS Monocular visual acuity was obtained from ninety-three 3 to 5-year-old children using Patti Pics and Lea Symbols. Acuities were also obtained from 113 adults using the same tests under identical conditions. Acuity results obtained with the pediatric tests were compared with the gold-standard Sloan Letter chart in adults. The Bland-Altman method was implemented to compare the level of agreement between tests. RESULTS Patti Pics yielded worse visual acuity than the Lea Symbols by approximately half a logMAR line in both children (mean difference: -0.07 ± 0.07 logMAR, p <0.01) and adults (Mean difference: -0.05 ± 0.06 logMAR, p <0.01). The 95% limits of agreement between Lea Symbol acuity and Patti pics acuity in children was ± 0.14 logMAR. Mean difference between the Sloan Letter chart and Lea Symbols acuity was not statistically significant (p = 0.08) in adults but the difference was statistically significant between PP and SL (p<0.001). The 95% limits of agreement between LS and SL and between PP and SL was ± 0.19 logMAR and ± 0.22 logMAR, respectively. CONCLUSION Patti Pics consistently underestimated visual acuity as compared to Lea Symbols both in children and adults although the differences were not clinically significant. The LS and PP did not yield clinically significant differences in acuities when compared with Sloan letters in adults.
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Affiliation(s)
| | - Sanjeeta Sitaula
- Department of Ophthalmology, B.P.Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Kathmandu, Nepal
| | - Gauri Shankar Shrestha
- Department of Ophthalmology, B.P.Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Kathmandu, Nepal
| | - Niraj Dev Joshi
- Department of Ophthalmology, B.P.Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Kathmandu, Nepal
| | | | - Nabin Paudel
- Center for Eye Research Ireland, Technological University Dublin, Ireland
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Anstice NS, Thompson B. The measurement of visual acuity in children: an evidence‐based update. Clin Exp Optom 2021; 97:3-11. [DOI: 10.1111/cxo.12086] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/02/2013] [Accepted: 04/16/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- Nicola S Anstice
- Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand,
| | - Benjamin Thompson
- Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand,
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Campo Dall'Orto G, Facchin A, Bellatorre A, Maffioletti S, Serio M. Measurement of visual acuity with a digital eye chart: optotypes, presentation modalities and repeatability. JOURNAL OF OPTOMETRY 2021; 14:133-141. [PMID: 33139229 PMCID: PMC8093539 DOI: 10.1016/j.optom.2020.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 06/08/2020] [Accepted: 08/17/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Digital or computerised eye charts are becoming standard in the examination of visual acuity. Each instrument allows the selection of different optotypes, presentation modalities, and crowding. The aim of this study was to examine the differences in visual acuity (VA) measurement using a digital eye chart, comparing different optotypes and procedures, together with an evaluation of the repeatability of the measurement. METHODS Two groups of 52 participants aged between 18 and 31 years participated in the study. In the first experiment, VA thresholds were measured using LEA Symbols, Tumbling E, and Landolt Rings in monocular and binocular conditions using single line presentation and QUEST presentation. In the second experiment, we have compared all modalities of presentation together with a paper eye-chart and test the repeatability. RESULTS The results showed that thresholds for LEA Symbols are low. The modality of presentation affects these thresholds. For Landolt Rings and Tumbling E, the QUEST procedure gave significantly better thresholds than line presentation, while this difference was absent for LEA Symbols. In comparing all modalities of presentation, single letter and line presentation showed similar values, slightly better than block presentation. Paper eye-charts showed better values of VA. Repeatability and agreement were good for all presentations, but best for QUEST. CONCLUSIONS The QUEST modality of presentation provides a better threshold than line presentation except for LEA Symbols. Examiners using digital eye charts must take into account that not all modalities of presentation and optotypes are equivalent and give different VA thresholds. Specific thresholds need to be used for each optotype and presentation modality.
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Affiliation(s)
| | - Alessio Facchin
- Department of Psychology, University of Milano Bicocca, Milano, Italy; Optics and Optometry Research Center, University of Milano Bicocca, Milano, Italy; Institute of Research and Studies in Optics and Optometry, Vinci, Italy.
| | | | - Silvio Maffioletti
- Degree Course of Optics and Optometry, University of Torino, Italy; Institute of Research and Studies in Optics and Optometry, Vinci, Italy
| | - Marina Serio
- Degree Course of Optics and Optometry, University of Torino, Italy; Department of Physics, University of Torino, Italy
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Leat SJ, Yakobchuk-Stanger C, Irving EL. Differential visual acuity - A new approach to measuring visual acuity. JOURNAL OF OPTOMETRY 2020; 13:41-49. [PMID: 31078445 PMCID: PMC6951827 DOI: 10.1016/j.optom.2019.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND A novel type of acuity measurement, which we refer to as 'differential acuity', requires the observer to identify one unique target among three others which are identical. This is a proof of concept study aimed to determine if differential acuity is equivalent to standard measures of recognition acuity. METHODS To create a range of visual acuity, vision was optically blurred in sixteen adults with normal visual acuity. Visual acuity was then measured with the differential acuity targets in both crowded and uncrowded format, and compared with standard ETDRS acuity or with singly presented letters and uncrowded letters were analysed separately. RESULTS The visual acuity results for crowded and uncrowded letters were analysed separately. Repeated measures analysis of variance showed that when a crowded Sloan C had to be differentiated from three crowded Os (CvsO), the results were not significantly different from ETDRS acuity or from naming one of four letters presented centrally (Name4) (p<0.05). Similar results were found for uncrowded letters - the C versus O and Name4 gave similar visual acuity. The 95% limits of agreement between the naming and C versus O differential acuity measures were between 0.17 and 0.27 logMAR. CONCLUSION From this proof of concept study we conclude that differential acuity gives similar results to the ETDRS chart in adults. We infer that the comparable but cognitively simpler differential visual acuity task could be applied in clinical settings for young children or patients with developmental delay who cannot respond by naming or matching.
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Affiliation(s)
- Susan J Leat
- School of Optometry and Vision Science, University of Waterloo, Canada.
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Drover JR, Cornick SL, Hallett D, Drover A, Mayo D, Kielly N. Normative pediatric data for three tests of functional vision. Can J Ophthalmol 2017; 52:198-202. [PMID: 28457291 DOI: 10.1016/j.jcjo.2016.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 08/31/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To provide the normative pediatric data for three tests of functional vision. DESIGN Prospective, cross-sectional study. PARTICIPANTS The participants were 281 children between 3 and 5 years of age (mean 4.2 ± 0.8 years) participating in a preschool vision screening study. METHODS Participants completed monocular testing with the Precision Vision Visual Acuity Testing (PVVAT) system, a computerized test of visual acuity. Stereoacuity was assessed using the Pass Test 3 Stereo Test. Noncycloplegic refractive error was measured using the Plusoptix S09 Vision Screener (PS09). The mean and 95% tolerance limits were determined for each test. RESULTS Visual acuity improved significantly from 0.31 logMAR at 3 years to 0.18 logMAR at 5 years (p < 2.4 × 10-15). Stereoacuity improved from 104 arcsec at 3 years to 81 arcsec at 5 years (p = 0.0058). Spherical refractive error remained relatively stable at 0.29 D at 3 years and 0.24 D at 5 years (p = 0.543). Cylindrical refractive error was also relatively stable, measuring 0.39 D at 3 years and 0.31 D at 5 years (p = 0.109). CONCLUSIONS Both visual acuity and stereoacuity improved significantly from 3 to 5 years of age. Note, however, that the norms obtained using the PVVAT system were somewhat lower than those reported in previous studies using other tests. The norms for the PS09 were stable and showed relatively good agreement with the manufacturer-suggested referral criteria.
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Affiliation(s)
- James R Drover
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL; Department of Pediatrics, Memorial University of Newfoundland, St. John's, NL.
| | - Shelley L Cornick
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL
| | - Darcy Hallett
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL
| | - Ashley Drover
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL
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Anstice NS, Jacobs RJ, Simkin SK, Thomson M, Thompson B, Collins AV. Do picture-based charts overestimate visual acuity? Comparison of Kay Pictures, Lea Symbols, HOTV and Keeler logMAR charts with Sloan letters in adults and children. PLoS One 2017; 12:e0170839. [PMID: 28152076 PMCID: PMC5289485 DOI: 10.1371/journal.pone.0170839] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/11/2017] [Indexed: 11/29/2022] Open
Abstract
Purpose Children may be tested with a variety of visual acuity (VA) charts during their ophthalmic care and differences between charts can complicate the interpretation of VA measurements. This study compared VA measurements across four pediatric charts with Sloan letters and identified chart design features that contributed to inter-chart differences in VA. Methods VA was determined for right eyes of 25 adults and 17 children (4–9 years of age) using Crowded Kay Pictures, Crowded linear Lea Symbols, Crowded Keeler logMAR, Crowded HOTV and Early Treatment of Diabetic Retinopathy Study (ETDRS) charts in focused and defocused (+1.00 DS optical blur) conditions. In a separate group of 25 adults, we compared the VA from individual Kay Picture optotypes with uncrowded Landolt C VA measurements. Results Crowded Kay Pictures generated significantly better VA measurements than all other charts in both adults and children (p < 0.001; 0.15 to 0.30 logMAR). No significant differences were found between other charts in adult participants; children achieved significantly poorer VA measurements on the ETDRS chart compared with pediatric acuity tests. All Kay Pictures optotypes produced better VA (p < 0.001), varying from -0.38 ± 0.13 logMAR (apple) to -0.57 ± 0.10 logMAR (duck), than the reference Landolt C task (mean VA -0.19 ± 0.08 logMAR). Conclusion Kay Pictures over-estimated VA in all participants. Variability between Kay Pictures optotypes suggests that shape cues aid in optotype determination. Other pediatric charts offer more comparable VA measures and should be used for children likely to progress to letter charts.
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Affiliation(s)
- Nicola S. Anstice
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Robert J. Jacobs
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Samantha K. Simkin
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Melissa Thomson
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Benjamin Thompson
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Andrew V. Collins
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
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Bušić M, Bjeloš M, Petrovečki M, Kuzmanović Elabjer B, Bosnar D, Ramić S, Miletić D, Andrijašević L, Kondža Krstonijević E, Jakovljević V, Bišćan Tvrdi A, Predović J, Kokot A, Bišćan F, Kovačević Ljubić M, Motušić Aras R. Zagreb Amblyopia Preschool Screening Study: near and distance visual acuity testing increase the diagnostic accuracy of screening for amblyopia. Croat Med J 2016; 57:29-41. [PMID: 26935612 PMCID: PMC4800325 DOI: 10.3325/cmj.2016.57.29] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM To present and evaluate a new screening protocol for amblyopia in preschool children. METHODS Zagreb Amblyopia Preschool Screening (ZAPS) study protocol performed screening for amblyopia by near and distance visual acuity (VA) testing of 15 648 children aged 48-54 months attending kindergartens in the City of Zagreb County between September 2011 and June 2014 using Lea Symbols in lines test. If VA in either eye was >0.1 logMAR, the child was re-tested, if failed at re-test, the child was referred to comprehensive eye examination at the Eye Clinic. RESULTS 78.04% of children passed the screening test. Estimated prevalence of amblyopia was 8.08%. Testability, sensitivity, and specificity of the ZAPS study protocol were 99.19%, 100.00%, and 96.68% respectively. CONCLUSION The ZAPS study used the most discriminative VA test with optotypes in line as they do not underestimate amblyopia. The estimated prevalence of amblyopia was considerably higher than reported elsewhere. To the best of our knowledge, the ZAPS study protocol reached the highest sensitivity and specificity when evaluating diagnostic accuracy of VA tests for screening. The pass level defined at ≤0.1 logMAR for 4-year-old children, using Lea Symbols in lines missed no amblyopia cases, advocating that both near and distance VA testing should be performed when screening for amblyopia.
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Affiliation(s)
| | - Mirjana Bjeloš
- Mirjana Bjeloš, University Eye Clinic, University Hospital "Sveti Duh", Sveti Duh 64, Zagreb, Croatia,
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Lalor SJ, Formankiewicz MA, Waugh SJ. Crowding and visual acuity measured in adults using paediatric test letters, pictures and symbols. Vision Res 2016; 121:31-38. [DOI: 10.1016/j.visres.2016.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 01/11/2016] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
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Abstract
Vision screening is crucial for the detection of visual and systemic disorders. It should begin in the newborn nursery and continue throughout childhood. This clinical report provides details regarding methods for pediatricians to use for screening.
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