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Updated: Mar 3, 2026
Author Spotlight: An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
Published on: March 17, 2023
Normative pediatric data for three tests of functional vision
James R Drover1, Shelley L Cornick2, Darcy Hallett2
1Department of Psychology, Memorial University of Newfoundland, St. John's, NL; Department of Pediatrics, Memorial University of Newfoundland, St. John's, NL.
Insights
Pediatric visual acuity and stereoacuity significantly improve between ages 3 and 5. This study provides normative data for these functional vision tests in young children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Science
Background:
- Establishing normative data for functional vision tests is crucial for identifying developmental delays in children.
- Previous studies have provided some pediatric vision norms, but data using specific modern testing systems may be limited.
Purpose of the Study:
- To establish normative pediatric data for three functional vision tests: Precision Vision Visual Acuity Testing (PVVAT), Pass Test 3 Stereo Test, and Plusoptix S09 Vision Screener (PS09).
- To analyze age-related changes in visual acuity, stereoacuity, and refractive error in preschool-aged children.
Main Methods:
- A prospective, cross-sectional study involving 281 children aged 3 to 5 years.
- Monocular visual acuity was measured using the PVVAT system.
- Stereoacuity was assessed with the Pass Test 3 Stereo Test, and refractive error was measured using the PS09 Vision Screener.
Main Results:
- Visual acuity (logMAR) significantly improved from 0.31 at 3 years to 0.18 at 5 years (p < 2.4 × 10-15).
- Stereoacuity (arcsec) improved significantly from 104 at 3 years to 81 at 5 years (p = 0.0058).
- Refractive error (spherical and cylindrical) remained relatively stable across the age range.
Conclusions:
- Significant improvements in visual acuity and stereoacuity occur between 3 and 5 years of age.
- Normative data from the PVVAT system were lower than previously reported norms from other tests.
- The PS09 norms were stable and aligned well with recommended referral criteria.
Objective:
To provide the normative pediatric data for three tests of functional vision.
Design:
Prospective, cross-sectional study.
Participants:
The participants were 281 children between 3 and 5 years of age (mean 4.2 ± 0.8 years) participating in a preschool vision screening study.
Methods:
Participants completed monocular testing with the Precision Vision Visual Acuity Testing (PVVAT) system, a computerized test of visual acuity. Stereoacuity was assessed using the Pass Test 3 Stereo Test. Noncycloplegic refractive error was measured using the Plusoptix S09 Vision Screener (PS09). The mean and 95% tolerance limits were determined for each test.
Results:
Visual acuity improved significantly from 0.31 logMAR at 3 years to 0.18 logMAR at 5 years (p < 2.4 × 10-15). Stereoacuity improved from 104 arcsec at 3 years to 81 arcsec at 5 years (p = 0.0058). Spherical refractive error remained relatively stable at 0.29 D at 3 years and 0.24 D at 5 years (p = 0.543). Cylindrical refractive error was also relatively stable, measuring 0.39 D at 3 years and 0.31 D at 5 years (p = 0.109).
Conclusions:
Both visual acuity and stereoacuity improved significantly from 3 to 5 years of age. Note, however, that the norms obtained using the PVVAT system were somewhat lower than those reported in previous studies using other tests. The norms for the PS09 were stable and showed relatively good agreement with the manufacturer-suggested referral criteria.
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