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Related Experiment Videos

Is the Cardiff Acuity Test effective in detecting refractive errors in children?

Claire Howard1, Alison Y Firth

  • 1Salford Primary Care Trust, Department of Orthoptics, Salford, UK. claire.howard@salford-pct.nhs.uk

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|August 16, 2006
PubMed
Summary

The Cardiff Acuity Test (CAT) may underdiagnose refractive errors in young children. The Bailey-Lovie Chart (BLC) is more effective for detecting reduced visual acuity in this population.

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Area of Science:

  • Ophthalmology
  • Pediatric Optometry

Background:

  • Refractive error is a primary cause of decreased visual acuity in young children, necessitating early detection to prevent amblyopia and educational delays.
  • The Bailey-Lovie Chart (BLC), a standard logarithmic minimum angle of resolution (logMAR) chart, is often too complex for very young children.
  • The Cardiff Acuity Test (CAT) is commonly used for preschool visual acuity screening due to its non-symbolic nature.

Purpose of the Study:

  • To evaluate the effectiveness of the Cardiff Acuity Test (CAT) in identifying reduced visual acuity attributable to refractive errors in young children.
  • To compare the diagnostic performance of the CAT with the Bailey-Lovie Chart (BLC) for refractive error detection.

Main Methods:

  • A crossover study design was employed, testing the right eye visual acuity of 68 children (mean age 74 months) with known refractive errors.

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  • Children were randomized to undergo testing with either the CAT or BLC first.
  • A pass criterion of 0.2 logMAR or better was used for both tests.

    • Main Results:

    • The CAT identified reduced visual acuity in only 25% of children with refractive errors, compared to 97% detected by the BLC.
    • Adjusting the CAT's threshold to 0.0 logMAR, as used clinically, improved its detection rate to 56% but still lagged behind the BLC.
    • The BLC demonstrated a significantly higher detection rate for refractive errors.

    Conclusions:

    • Current clinical practice relying solely on the Cardiff Acuity Test (CAT) may lead to underdiagnosis of reduced visual acuity caused by refractive errors in young children.
    • The findings question the adequacy of the CAT as a standalone screening tool for refractive errors in pediatric populations.
    • Further research may be needed to refine screening protocols for young children with potential refractive errors.