Effect of simulated refractive error on adult visual acuity for paediatric tests

Paudel, Nabin; Jacobs, Robert J.; Sloan, Richard G.; Denny, Sarah; Shea, Kimberley; Thompson, Benjamin; Anstice, Nicola

doi:10.1111/opo.12387

Cited by 7 publications

(13 citation statements)

References 34 publications

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“…The Cardiff Acuity Test is useful for estimating acuity in very young children and those with cognitive difficulties (Adoh et al, 1992). However, results do not align well with recognition acuity tests using regular optotypes (Paudel et al, 2017), perhaps due to perception of vanishing compared to regular optotypes, or perhaps because of the testing protocol. It would therefore be useful to compare measures of acuity made with vanishing and regular versions of identical optotypes with the same test protocol, as has been done with Sloan letters (Shah et al, 2011;Shah et al, 2012;Shah, Anderson, Tufail, Egan, & Dakin, 2013;Shah et al, 2014).…”

Section: Introductionmentioning

confidence: 96%

The Auckland Optotypes: An open-access pictogram set for measuring recognition acuity

et al. 2018

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When measuring recognition acuity in a research setting, the most widely used symbols are the Early Treatment of Diabetic Retinopathy Study (ETDRS) set of 10 Sloan letters. However, the symbols are not appropriate for patients unfamiliar with letters, and acuity for individual letters is variable. Alternative pictogram sets are available, but are generally comprised of fewer items. We set out to develop an open-access set of 10 pictograms that would elicit more consistent estimates of acuity across items than the ETDRS letters from visually normal adults. We measured monocular acuity for individual uncrowded optotypes within a newly designed set (The Auckland Optotype [TAO]), the ETDRS set, and Landolt Cs. Eleven visually normal adults were assessed on regular and vanishing formats of each set. Inter-optotype reliability and ability to detect subtle differences between participants were assessed using intraclass correlations (ICC) and fractional rank precision (FRP). The TAO vanishing set showed the strongest performance (ICC = 0.97, FRP = 0.90), followed by the other vanishing sets (Sloan ICC = 0.88, FRP = 0.74; Landolt ICC = 0.86, FRP = 0.80). Within the regular format, TAO again outperformed the existing sets (TAO ICC = 0.77, FRP = 0.75; Sloan ICC = 0.65, FRP = 0.64; Landolt ICC = 0.48, FRP = 0.63). For adults with normal visual acuity, the new optotypes (in both regular and vanishing formats) are more equally legible and sensitive to subtle individual differences than their Sloan counterparts. As this set does not require observers to be able to name Roman letters, and is freely available to use and modify, it may have wide application for measurement of acuity.

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Section: Introductionmentioning

confidence: 96%

The Auckland Optotypes: An open-access pictogram set for measuring recognition acuity

et al. 2018

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“…45 Previously research has shown nearly equal VA reductions with induced spherical and cylindrical defocus for both letter optotypes and Lea symbols. 46 Furthermore, the lower specificity of the Parr vision test compared with the Lea symbols indicates a larger number of false positive results, thereby suggesting a lower number of correct guesses at threshold. The results of the current study indicate the Parr vision test provides an acceptable paediatric vision screening tool, with a shorter testing time than Lea symbols.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of the Parr vision test, single crowded Lea symbols and Spot vision screener for vision screening of preschool children aged 4–5 years in Aotearoa/New Zealand

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Goodman

et al. 2021

Ophthalmic Physiologic Optic

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Purpose Preschool children in New Zealand undergo vision screening to detect amblyopia at 4–5 years of age. The current test, the Parr vision test, does not meet international visual acuity chart guidelines and has not been validated against other commonly used paediatric vision tests. New Zealand vision screening protocols are also not targeted for detecting other eye conditions such as uncorrected refractive error, which may affect school performance. We compared the Parr vision test with the single crowded Lea symbols and the Spot vision screener for detecting ocular pathology, refractive error and amblyopic risk factors in preschool children. Methods A cross‐sectional diagnostic accuracy study recruited children aged 4–5 years via convenience sampling from the University of Auckland Optometry Clinic and through primary schools in Auckland, New Zealand. Participants received vision screening with the three different instruments administered by a lay screener. Comprehensive eye examinations were completed by a paediatric optometrist to determine the presence of vision disorders. Results Of 197 children who received a comprehensive eye examination, 14 (7.1%) had amblyopic risk factors and 43 (21.8%) had significant refractive error (15.7% with astigmatism, 9.1% with hyperopia). The sensitivity for detecting any ocular condition did not differ significantly between the tests (50.0% for Parr, 43.5% for Lea, 42.5% for Spot). Specificity was significantly lower for the Parr vision test (80.8%) than for the Lea symbols (93.4%) and Spot vision screener (98.0%). Adding the Spot vision screener to measurements of visual acuity significantly improved sensitivity in detecting any ocular condition with the Parr vision test (67.5% for Parr/Spot vs 50% for Parr alone), but not with the Lea symbols (52.5% for Lea/Spot vs 43.5% for Lea alone). Conclusion The sensitivity of the Parr vision test for detecting ocular conditions in preschool children does not vary significantly from that achieved by the Lea symbols or the Spot vision screener. However, current New Zealand vision screening protocols could be improved by expanding the target conditions to include significant refractive error and incorporating the use of the Spot vision screener to increase the accuracy with which children with refractive error are identified. Future research should include longitudinal studies to determine the effect of preschool vision screening on later ocular and academic outcomes.

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“…The Cardiff Acuity Test is significantly less sensitive than recognition acuity tasks, such as the Lea Symbols, for detecting refractive errors. 18,19,30 Nevertheless, recognition acuity measures are difficult to achieve in children younger than 36 months 31 and cooperation for monocular visual acuity measures is particularly challenging. 32…”

Section: Discussionmentioning

confidence: 99%

“…15,16 Nevertheless, vanishing optotypes may be more resistant to optical defocus than recognition acuity tasks and therefore may have reduced sensitivity for detecting refractive errors. 18,19 Consequently, automated preschool vision screening tests, such as autorefraction or the Pediatric Vision Screener 20 have been suggested as better screening methods for detecting amblyopia and/or amblyopia risk factors in 12-30 month old children. 21…”

Section: Introductionmentioning

confidence: 99%

Vision screening at two years does not reduce the prevalence of reduced vision at four and a half years of age

Goodman

Chakraborty

Paudel

et al. 2018

Clinical and Experimental Optometry

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Effect of simulated refractive error on adult visual acuity for paediatric tests

Cited by 7 publications

References 34 publications

The Auckland Optotypes: An open-access pictogram set for measuring recognition acuity

The Auckland Optotypes: An open-access pictogram set for measuring recognition acuity

Diagnostic accuracy of the Parr vision test, single crowded Lea symbols and Spot vision screener for vision screening of preschool children aged 4–5 years in Aotearoa/New Zealand

Vision screening at two years does not reduce the prevalence of reduced vision at four and a half years of age

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