Can children measure their own vision? A comparison of three new contrast sensitivity tests

Abstract

PurposeTo investigate the feasibility of children measuring their own contrast sensitivity using a range of tablet‐ and paper‐based tests.MethodsForty children aged 5–15 years with amblyopia (N = 10), bilateral vision impairment (N = 10) or good vision (N = 20) measured their own vision on a screen‐based optotype test (Manifold), a gamified vision test (PopCSF) and a paper‐based test (Spotchecks) in a laboratory with minimal supervision. Completion rate, test–retest repeatability, test duration and participants' preferences were recorded for each test.ResultsMost participants (36/40) were able to perform all three tests. All tests were correlated with clinically measured visual acuity and contrast sensitivity (p < 0.001). The 95% coefficient of repeatability was 0.30 dB for Manifold, 0.29 dB for PopCSF and 0.13 dB for Spotchecks. All tests differentiated between children with reduced contrast sensitivity and control participants. PopCSF and Spotchecks were also able to differentiate between children with amblyopia and those with good vision. Median test time was 152, 130 and 202 s for Manifold, PopCSF and Spotchecks, respectively. Twenty‐two participants preferred the PopCSF test, 10 preferred Spotchecks and 6 preferred Manifold. Thirty‐nine out of the 40 children (98%) said they would measure their own vision at home using at least one of these tests every month.ConclusionsChildren and young people can test their own contrast sensitivity with repeatable results. Of these three tests, the most repeatable was Spotchecks, the quickest was PopCSF and participants' favourite was PopCSF. Nearly all of the participants said they would be willing to use at least one of the three tests at home.

Evaluation of the SpotChecks contrast sensitivity test in healthy adults

“…50 The inclusion of the game-like element in locating 'spots' could enhance attention span, potentially making SpotChecks useful for children or individuals facing cognitive challenges. 14,21 In a recent study that demonstrated the feasibility of home testing with SpotChecks for children, when compared to two electronic CS tests, SpotChecks provided 100% completion rate, better test-retest repeatability and was preferred by older children. 14 Future studies with SpotChecks will verify its utility in patients with optic nerve or macular diseases.…”

“…14,21 In a recent study that demonstrated the feasibility of home testing with SpotChecks for children, when compared to two electronic CS tests, SpotChecks provided 100% completion rate, better test-retest repeatability and was preferred by older children. 14 Future studies with SpotChecks will verify its utility in patients with optic nerve or macular diseases. 51 In individuals with impaired vision, several authors have demonstrated that measurements such as CS from the Pelli-Robson chart and high-contrast VA are sufficient to predict an individual's full CS function in the majority of patients.…”