Assessment of visual acuity in children aged 1½-6 years, with normal and subnormal vision

Abstract

The aim of the study was to assess different visual acuity tests in the age group 1 1/2-6 years in 105 children with assumed normal vision, visual impairment due to ocular disease or strabismus. Acuity tasks for young children can be divided into three subtypes according to the kind of stimulus used. For "detection acuity", the stimulus should be detected or distinguished from the background, as assessed with the Stycar Rolling Balls. For "resolution acuity", the stimulus pattern should be resolved, as assessed with the Preferential Looking procedure (Teller Acuity Cards). For "recognition acuity", the stimulus must be recognized by the subject as assessed with the BUST-D symbol test, Sheridan Gardiner (S-G) single letters, LH single symbols and line tests, and also the HVOT test. Different acuity values were obtained with regard to detection, resolution and recognition acuities. Assessment with the Stycar Rolling Balls only gave a rough estimate of the visual function. There was an overestimation of the acuity values in all groups of children when using the Preferential Looking technique. Good agreement was found between the LH line and HVOT tests. The BUST-D test, S-G single letters, and LH single symbols gave slightly better acuity values than linear recognition tests. A "crowding ratio" was calculated by dividing the single optotype acuity by the linear acuity, and also by dividing the grating acuity by the optotype linear and single acuity. The crowding ratio varied in the individual children and in the different groups, being highest for strabismic amblyopia. The general conclusion is that reliable visual acuity measurements were not obtained until the visual acuity could be assessed with a recognition test using linear letters or symbols.

Ophthalmological findings in 10‐year‐old full‐term children – a population‐based study

“…However, a certain amount of crowding has been observed in normal children (Rydberg et al 1999;Dekker et al 2012) -something that was confirmed in the present study. The mean value of approximately 1.1 was somewhat lower than that found by Atkinson et al (1988) (1.2 at 5-7 years of age) and Dekker et al (2012) (1.3 at 6-12 years of age).…”

A comparison of visual function scores in hydrocephalic infants with and without lumbosacral myelomeningocoele

“…The evaluation of visual function in infants remains difficult despite the availability of tests designed to circumvent lack of cooperation and verbal ability. 10,11 It is therefore customary to assess multiple parameters of visual function in studies in this age group. 11,14 In accordance with this principle we have assessed visual function by evaluating visual fixation and tracking, pupillary size and reaction, and assessment of the optic disc and integrated the results into a numerical scoring scale for ease of analysis and interpretation.…”

“…7,8 Furthermore, in patients with cerebral visual impairment secondary to non-focal cerebral lesions, ultrasonographic appearance of the brain, visual, motor and cognitive functions are closely correlated. [9][10][11] and visual function can be an important predictor of cognitive development. The development of perceptual and motor skills also depends on visual function.…”

Oculomotor dysfunction in cerebral visual impairment following perinatal hypoxia

“…When possible, Snellen's optotype and Albini's E were used (Lueder and Garibaldi 1997); in preverbal age Pigassou's pictures (Pigassou and Pincon 1969) or Mentor-B vat's pictures were used as were the Vis Test and Bust Cards (Rydberg et al 1999). Keeler Acuity Cards or Visual Quotient (Salati 2001) was administered to children who found it difficult to cooperate.…”