Comparison of visual acuity results in preschool children with lea symbols and bailey-lovie e chart

Sanker, Nijil; Dhirani, Sayyeda; Bhakat, Premjit

doi:10.4103/0974-9233.120020

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…2 Almost every other study also found that preschool children tended to be more cooperative with Lea symbols. 1,11,14 However, a 2017 study found a 5-11% better testability rate with Tumbling E in children aged 3-4 years compared to previous studies which was hypothetically connected with stimulation of spatial orientation through a smartphone. 4 We had no evidence of this hypothesis in our study because our subjects were from lower income families so their exposure to smartphones was limited.…”

Section: Resultsmentioning

confidence: 92%

Visual acuity assessment of preschool children in the inner city area in Jakarta

Yulia

Laksmita

Barliana

et al. 2021

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Background Visual acuity (VA) assessment is an important ocular examination to identify children with vision problems. Such early identification allows for early intervention to prevent childhood blindness. Objective To describe and compare visual acuity measurements in preschool children using two different visual acuity charts. Methods This cross-sectional study in children aged 36-60 months was done in a low-income area in the Central Jakarta District as a collaboration between Department of Ophthalmology and Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta. All children underwent visual acuity examinations using Lea symbols and Tumbling E charts. The VA results from two charts were analyzed with Bland-Altman plot for limits of agreement. Statistical analyses were performed to determine the differences between vision charts. Results A total of 113 children enrolled, but only 38 children completed the examinations. The mean age of subjects was 50.5 (SD 6.4) months. Overall, subjects’ mean VA was 0.29 (SD 0.18) for Lea symbols and 0.37 (SD 0.14) for Tumbling E. The mean difference of VA between Lea symbols and Tumbling E was 0.07 (SD 0.22) logMAR units, with upper and lower limits of agreement at 0.36 and 0.51, respectively. There was no statistical difference in VA score using Lea symbols and Tumbling-E based on gender and age. Conclusion Most preschool children in our study have normal visual acuity. Lea symbols and Tumbling E chart are comparable and can be used to efficiently measure VA in preschool children.

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Section: Resultsmentioning

confidence: 92%

Visual acuity assessment of preschool children in the inner city area in Jakarta

Yulia

Laksmita

Barliana

et al. 2021

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“…The current study findings were consistent with their results. Sanker et al observed the Tumbling E chart to be as good as Lea in assessing visual acuity of preschoolers, especially for five‐ to six‐year‐olds, while they recommended Lea for three‐ to four‐year‐olds. Cotter et al found better visual acuity scores with Lea in three‐ to five‐year‐olds compared to HOTV.…”

Section: Discussionmentioning

confidence: 99%

“…Published literature in this arena provided inconclusive results. Lea charts have been recommended by various authors . HOTV has been reported to be the most commonly used chart in the USA .…”

mentioning

confidence: 99%

Diagnostic accuracy and agreement between visual acuity charts for detecting significant refractive errors in preschoolers

Thomas

Rajashekar

Kamath

et al. 2020

Clinical and Experimental Optometry

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Background Preschool vision screenings are considered to be cost‐effective methods to identify children with vision disorders. The children of this age group are poor at communicating their symptoms and hence screening is mandated. This study is aimed at estimating the diagnostic accuracy and agreement of Lea, HOTV and E visual acuity charts for detecting significant refractive errors. Methods A cross‐sectional study was conducted, in which monocular unaided vision assessment of each study participant was performed with Lea, HOTV and E charts. Stereo acuity was measured with the Randot Preschool Test and a comprehensive eye examination including dilatation was performed. Significant refractive error was defined as hyperopia > 3.25 D, myopia > 2.00 D, astigmatism > 1.50 D, anisometropia if interocular difference > 1.00 D for hyperopia, > 3.00 D for myopia or > 1.50 D for astigmatism. Sensitivity, specificity, positive and negative predictive values were estimated. Bland–Altmann plots were generated to help identify the level of agreement between the vision charts. Results A total of 256 eyes were analysed. Lea, HOTV and E had sensitivities of 87.8 per cent, 90.2 per cent and 90.2 per cent, respectively. Specificity and positive predictive values were better for HOTV (77.3 per cent, 65.5 per cent) and Lea (75 per cent, 62.6 per cent), compared to E chart (69.8 per cent, 58.7 per cent). Negative predictive values for Lea, HOTV and E charts were 92.8 per cent, 93.8 per cent and 93.8 per cent, respectively. Bland–Altmann analysis showed good agreement between Lea and HOTV, Lea and E, and HOTV and E visual acuity charts. The acuity difference was least between Lea and HOTV charts (0.1 logMAR). Eighty‐five (33.2 per cent) eyes had significant refractive errors. Eighty (94.1 per cent) eyes were astigmatic. Conclusion The diagnostic accuracy of the visual acuity charts was high for the identification of significant refractive errors in preschool children. There was very good agreement between the visual acuity charts.

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“…Different visual acuity chart has its advantages, disadvantages, and applicable age. Many studies established that Lea's visual acuity has better sensitivity in preschool vision screening [6][7][8][9][10]. As Lea Symbols visual acuity chart was expensive and not easy to buy in China, it was worth to evaluate the advantages and disadvantages in large-scale vision screening in schoolchildren.…”

Section: Introductionmentioning

confidence: 99%

Pinhole does not increase screening accuracy of detecting decreased best corrected visual acuity in schoolchildren

Chen

Sun

et al. 2021

BMC Ophthalmol

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Background Decreased best corrected visual acuity among children should be treated early in life, and vision screening in schoolchildren is an efficient and feasible selection for developing countries. Thus, the screening accuracy of different visual acuity tests is the key point for making vision screening strategies. The present study aims to explore the screening accuracy of uncorrected visual acuity (UCVA) and pin-hole corrected visual acuity (PCVA) using different vision chart in the detection of decreased best-corrected visual acuity (BCVA) among schoolchildren. Methods Grade one primary schoolchildren in urban Lhasa with data of UCVA using tumbling E chart (UCVAE), PCVA using tumbling E chart (PCVAE), UCVA using Lea Symbols chart (UCVAL), PCVA using Lea Symbols chart (PCVAL) and BCVA using Lea Symbols chart were reviewed. Decreased BCVA was defined as BCVA≤20/32(≥0.2 logMAR). Difference, reliability, and diagnostic parameters in the detection of decreased BCVA of different visual acuity results were analyzed. Results Overall, 1672 children aged 6.58 ± 0.44 years fulfilling the criteria. The prevalence of decreased BCVA was 6.8%. Although no significant differences were found between UCVAE vs UCVAL (p = .84, paired t-test) as well as PCVAE vs PCVAL (p = .24), the ICC between them was low (0.68 and 0.57, respectively). The average difference between BCVA and UCVAE, UCVAL, PCVAE, PCVAL was logMAR -0.08 (− 0.37, 0.21), − 0.08 (− 0.29, 0.17), − 0.05 (− 0.30, 0.19), − 0.06 (− 0.23, 0.12) using Bland–Altman method. The area under the receiver operating characteristic curve of UCVAE, PCVAE, UCVAL, PCVAL for the detection of decreased BCVA was 0.78 (0.73, 0.84), 0.76 (0.71, 0.82), 0.95 (0.94, 0.96), 0.93 (0.91, 0.95), respectively. Conclusion Pinhole does not increase the screening accuracy of detecting decreased BCVA in grade one primary schoolchildren. Visual acuity test using Lea Symbols is more efficient than Tumbling E in the screening of that age. Trial registration Data were maily from the Lhasa Childhood Eye Study which has finished the clinical registration on (ChiCTR1900026693).

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Comparison of visual acuity results in preschool children with lea symbols and bailey-lovie e chart

Cited by 11 publications

References 17 publications

Visual acuity assessment of preschool children in the inner city area in Jakarta

Visual acuity assessment of preschool children in the inner city area in Jakarta

Diagnostic accuracy and agreement between visual acuity charts for detecting significant refractive errors in preschoolers

Pinhole does not increase screening accuracy of detecting decreased best corrected visual acuity in schoolchildren

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