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Related Experiment Video

Updated: Jul 14, 2026

An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
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An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System

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Reliability of three different visual acuity testing procedures in school children.

A Schmidt-Bacher1, M Pritsch, G Kolling

  • 1Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany. Annette.SchmidtBacher@med.uni-heidelberg.de

Strabismus
|May 25, 2007
PubMed
Summary

This study assessed visual acuity (VA) testing in children using Landolt C

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Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Vision Science

Background:

  • Accurate visual acuity (VA) measurement is crucial for early detection of vision impairments in school children.
  • Traditional VA testing methods can be challenging with young children.
  • Computer-based testing offers potential for improved efficiency and reliability.

Purpose of the Study:

  • To evaluate the usability and reliability of three distinct visual acuity testing procedures.
  • To assess the performance of a semi-automated computer program using Landolt C's in school children.
  • To compare the test-retest reliability and testing time of different VA testing strategies.

Main Methods:

  • 100 school children (median age 7 years) participated, with only the better eye tested.

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  • A semi-automated computer program, CORVIS.VT, was used with a forced-choice method.
  • Three test strategies were employed: DIN, Standard-Staircase, and Best-PEST, each administered twice.

    • Main Results:

    • Testing times varied: DIN (100s ± 45s), Staircase (59s ± 36s), and Best-PEST (77s ± 25s).
    • Mean VA estimated by DIN and Best-PEST were comparable, while Standard-Staircase yielded a lower mean VA.
    • Test-retest reliability (within 0.1 logMAR) was highest for DIN (76%), followed by Best-PEST (73%) and Staircase (72%).

    Conclusions:

    • Landolt C's in 8 positions are suitable for testing 98% of children aged 6-9 years.
    • The DIN procedure demonstrated the highest test-retest reliability, followed by Best-PEST and Standard-Staircase.
    • Computer-assisted VA testing with Landolt C's is feasible and reliable in school-aged children.