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Updated: May 24, 2026
An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
Published on: March 17, 2023
[Evaluation of grating visual acuity development in normal infants]
Yang Qiu1, Xiao-qing Li, Xiao-ming Yan
1Department of Ophthalmology, Peking University First Hospital, Beijing 100034, China.
Insights
Grating visual acuity in Chinese infants significantly improves with age, reaching near-adult levels by 24 months. The Teller Acuity Card (TAC) is a practical tool for assessing infant visual development.
Area of Science:
- Ophthalmology and Visual Science
- Developmental Pediatrics
Context:
- Assessing infant visual acuity is crucial for early detection of visual impairments.
- Understanding normal visual development provides benchmarks for clinical evaluation.
Purpose:
- To establish age-specific grating visual acuity norms for Chinese infants aged 5 to 24 months.
- To evaluate the developmental trajectory of visual acuity in this population.
- To assess the utility of the Teller Acuity Card II for infant vision screening.
Summary:
- A study involving 244 Chinese infants (5-24 months) utilized the Teller Acuity Card II to measure grating visual acuity.
- Binocular and monocular acuities were recorded, showing a progressive increase with age, with acuity approaching adult levels by 24 months.
- The Teller Acuity Card II proved practical and efficient for assessing infant visual acuity, with tests completed in 2-5 minutes.
Impact:
- Provides normative data for grating visual acuity in Chinese infants, aiding clinical diagnosis and research.
- Demonstrates the feasibility and effectiveness of the Teller Acuity Card II in infant vision assessment.
- Highlights distinct phases in visual acuity development, with accelerated progress after 15 months.
Objective:
To assess the grating visual acuity of Chinese normal infants from 5 to 24 months, evaluate the development of grating visual acuity in infants.
Methods:
The Teller acuity card(TM) II (Stero-Optical Company, America) was used to assess the grating visual acuity of 244 infants aged from 5 to 24 months, who met the eligible criteria. Binocular visual acuity and monocular visual acuity were both assessed. They were divided into 19 groups according to their age sequence from 5 to 24 months. Average binocular and monocular visual acuity of every group were recorded and calculated. The relationship between visual acuity and age were analyzed. The practicality and possibility of the application for the Teller acuity card in infants were assessed.
Results:
Binocular visual acuity was obtained in 241 infants (98.77%). Monocular visual acuity from both eyes was completed in 89.2% infants. All the tests can be finished in 2 to 5 minutes. The average of binocular visual acuities of the 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 21, 24 months separately was: 0.17, 0.21, 0.22, 0.23, 0.23, 0.25, 0.26, 0.30, 0.33, 0.32, 0.37, 0.39, 0.42, 0.47, 0.56, 0.60, 0.83. The average of monocular visual acuities separately was: 0.15, 0.19, 0.19, 0.20, 0.20, 0.21, 0.21, 0.27, 0.23, 0.26, 0.24, 0.35, 0.26, 0.41, 0.40, 0.56, 0.80. The binocular visual acuity was slightly higher than the monocular visual acuity. The difference was less than one octave. The intraocular acuity difference was less than one octave. There were no significant differences between left and right eyes. Visual acuity of the infants aged form 5 to 14 months increased slowly from 5.1 to 9.6cpd, about 1 octave. There was an increase started from 15 months. Everyone who was reached 24 months got a visual acuity of 26cpd (snellen = 0.833), closed to the adult level. Compared to the visual acuity of 12 months age, 1.5 octaves were increased.
Conclusions:
TAC is useful and practical for age norms of visual acuity of infants in clinical and vision research. Visual acuity increases progressively with age. The development of visual acuity shows a different speed in different age period. Monocular visual acuity is slightly lower than binocular visual acuity. There is a balanced visual development of both eyes.
