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Rarebit fovea test in children: reference data for children aged six to 10 years
Maria Nilsson1, Maria Svanberg, Sara Schalin
1Unit of Optometry, Department of Clinical Neuroscience, Karolinska Insitutet, Stockholm, Sweden. maria.nilsson@ki.se
Insights
The Rarebit fovea test effectively detects early vision problems in children aged 6-10 years. Repeated testing showed improved performance, indicating its potential for assessing foveal function in pediatric vision screening.
Area of Science:
- Ophthalmology
- Pediatric Vision Screening
- Visual Function Testing
Background:
- Traditional visual acuity tests using letter charts are common but may miss early signs of foveal dysfunction.
- The Rarebit fovea test (RFT) was developed to detect subtle foveal function deficits before they impact visual acuity.
- Previous RFT studies in children were limited by small sample sizes, necessitating further research for establishing reference values.
Purpose of the Study:
- To establish reference values for the Rarebit fovea test in a larger group of children aged 6-10 years.
- To evaluate the learning effect associated with repeated RFT administrations in this age group.
- To assess the tolerability and reliability of the RFT in pediatric populations.
Main Methods:
- The study involved 108 children aged 6-10 years undergoing RFT as part of a school screening program in Stockholm, Sweden.
- All participants had good visual acuity and minor refractive errors.
- Each child completed two RFT examinations during a single session.
Main Results:
- Median mean hit rates on the RFT ranged from 94.0% to 97.5% across different age subgroups (pre-school to third-year).
- The overall median mean hit rate for all children was 96%, with individual results varying from 57% to 100%.
- Third-year children performed significantly better than pre-school and first-year children, and all groups showed significant improvement from the first to the second test.
Conclusions:
- The Rarebit fovea test is well-tolerated by children aged 6-10 years.
- Over 90% of children in the study produced reliable RFT results, comparable to adult norms.
- The RFT shows promise for evaluating foveal function in children, warranting further investigation.
Introduction:
The most common way to examine vision is to measure visual acuity using letter charts. The Rarebit fovea test was developed for detection of small defects of foveal function at a stage before they cause abnormal visual acuity. In a recent study, the RFT was well tolerated in a smaller group of children between seven and nine years of age; however, the number of subjects in that study was small for the determination of reference values, and therefore the aim of the present study was to establish reference values for a larger group of children aged between six and 10 years and to evaluate the learning effect after repeated tests.
Methods:
Rarebit fovea test data were collected from a group of 108 subjects aged between six and 10 years as part of a screening program at a compulsory school in Stockholm, Sweden. All subjects had good visual acuity and minor refractive errors. They underwent two Rarebit fovea test examinations on one occasion.
Results:
Rarebit fovea test results ranged from a median mean hit rate of 94.0 to 97.5 per cent for pre-school and third-year children, respectively. For the entire group of children the median mean hit rate was 96 per cent (range 57 to 100). The third-year children performed significantly better than the pre-school (p < 0.01) and first-year children (p < 0.05). A significant improvement from the first to second test run was noticed in all groups.
Conclusion:
The Rarebit fovea test proved to be well tolerated among children in a group of six to 10 year olds and more than 90 per cent of children were considered to give reliable results close to what is normal for adults. It would be interesting to further investigate the potential of the Rarebit fovea test for evaluation of foveal function in children.
