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Updated: Aug 20, 2026
An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
Published on: March 17, 2023
Visual acuity in premature infants
Abraham Spierer1, Zana Royzman, Jacob Kuint
1Goldschleger Eye Institute, Neonatal Department, Sheba Medical Center, Tel-Hashomer, Israel. spierera@post.tau.ac
Insights
Premature infants show significantly worse visual acuity than full-term infants at six months chronological age. This visual impairment is mainly due to the immaturity of the visual system in preterm infants.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Premature infants are at higher risk for visual impairments.
- Assessing visual acuity in infants is crucial for early detection and intervention.
Purpose of the Study:
- To measure grating visual acuity in premature infants.
- To compare visual acuity between premature and full-term infants at 6 months of age.
Main Methods:
- The study involved 73 premature and 73 full-term infants tested at 6 months chronological age using the Teller Acuity Card procedure.
- Premature infants underwent indirect funduscopy for retinopathy of prematurity (ROP) screening.
- Mean gestational age for premature infants was 33 weeks; mean birth weight was 1,906g.
Main Results:
- Impaired binocular visual acuity was observed in 53.4% of premature infants versus 11% of full-term infants (p < 0.0001).
- Impaired monocular visual acuity was found in 13.7% of premature infants compared to 2.7% of full-term infants.
- Within the premature group, ROP was associated with impaired monocular visual acuity (42.9% with ROP vs. 10.6% without ROP, p=0.0497).
Conclusions:
- Premature infants exhibit significantly poorer monocular and binocular visual acuities compared to full-term infants at the same chronological age.
- The primary cause of reduced visual acuity in premature infants is attributed to visual system immaturity.
- Early assessment of visual acuity is vital for identifying potential developmental delays in preterm infants.
Purpose:
To measure grating visual acuity in premature infants and compare it with that in full-term infants.
Methods:
The visual acuity of 73 premature and 73 full-term infants was tested at 6 months of age by the Teller Acuity Card procedure. All premature infants had undergone indirect funduscopy for the detection of retinopathy of prematurity (ROP). Seven infants had developed ROP. The mean gestational age of the premature infants was 33 +/- 1.4 weeks as compared with 39.9 +/- 0.9 weeks in the full-term infants. The mean birth weights of the 2 groups were 1,906 +/- 412 and 3,244 +/- 420 g, respectively.
Results:
Impaired binocular visual acuity was found in 53.4% of the premature infants, but in only 11% of the full-term infants (p < 0.0001). Impaired monocular visual acuity was found in 13.7% of the premature infants as compared with 2.7% of the full-term infants. Within the premature infant group, monocular visual acuity was impaired in 42.9% of those with ROP and in 10.6% of those without ROP (p = 0.0497). Pathological refraction was found in 33.3% of the prematures without ROP and in 14.3% of the prematures with ROP. This difference was not statistically significant. Visual acuity of preterm infants was not different from full-term infants when examined at 6 months of postconceptual age.
Conclusions:
Both monocular and binocular visual acuities as measured by the Teller Acuity Cards are worse in premature infants than in full-term infants at the same chronological age. Poor visual acuity in premature infants can be attributed mainly to immaturity of the visual system.
