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The measurement of visual acuity in children: an evidence-based update
Nicola S Anstice1, Benjamin Thompson
1Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand. n.anstice@auckland.ac.nz.
Insights
This review examines the reliability and accuracy of pediatric vision tests for diagnosing and managing childhood eye diseases. It highlights age-appropriate tests and discusses visual acuity norms for children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
Background:
- Recent clinical trials have advanced understanding of pediatric vision test reliability and repeatability.
- These tests are crucial for diagnosing and managing pediatric ocular diseases.
Purpose of the Study:
- To review current pediatric visual acuity (VA) testing methods in clinical practice.
- To evaluate the validity and accuracy of VA measurements in infants and young children.
- To discuss age-specific VA tests, normative values, and optotype design impact.
Main Methods:
- Literature review of large clinical trials and studies on pediatric vision assessment.
- Synthesis of findings on the reliability, repeatability, validity, and accuracy of VA tests.
- Comparison of different VA tests, focusing on optotype characteristics.
Main Results:
- Established reliability and repeatability data for common pediatric vision tests.
- Identified age-appropriate VA tests for infants through school-aged children.
- Provided normative VA values and highlighted the influence of optotype design on results.
Conclusions:
- Accurate VA measurement is vital for pediatric eye care.
- Selection of appropriate tests and understanding optotype design are key for reliable pediatric vision screening.
- Continued research is needed to refine VA testing in young children.
Abstract:
Over the past decade, a number of large clinical trials have provided important information relating to the reliability and repeatability of commonly used paediatric tests of vision and their role in the diagnosis and management of paediatric ocular diseases. The aim of this review is to summarise recent findings on the use of paediatric visual acuity tests in clinical practice and to discuss the validity and accuracy of visual acuity measurements in infants and young children. We provide a broad overview of the benefits and challenges of measuring visual acuity in children and then discuss age-appropriate tests for measuring visual acuity in infants through to school-age children. We also discuss normative values for visual acuity in each age group and, where possible, provide comparisons of results between tests with a particular focus on the importance of optotype design.
