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Author Spotlight: An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
Published on: March 17, 2023
Colour vision testing in young children with reduced visual acuity
Oliver Andreas Pfäffli1, Bálint Tamási2, James V M Hanson1
1Department of Ophthalmology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Insights
Pseudoisochromatic (PIC) and Mollon-Reffin minimalist (MRM) tests are feasible for assessing color vision in children with reduced visual acuity. The Cambridge Colour Test (CCT) showed lower feasibility in younger children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Color Vision Research
Background:
- Assessing color vision in children with reduced visual acuity is crucial for early diagnosis and management.
- Existing color vision tests may have limitations in terms of feasibility and reliability in young populations.
Purpose of the Study:
- To evaluate the feasibility, reliability, and discriminative validity of pseudoisochromatic (PIC) tests, the Mollon-Reffin minimalist (MRM) test, and the Cambridge Colour Test (CCT).
- To assess these tests in children aged 3-10 years with reduced visual acuity.
Main Methods:
- A prospective study involving 33 patients with reduced visual acuity and 38 age-matched healthy controls.
- Visual acuity reduction was due to amblyopia, binocular maculopathy, or optic neuropathy.
- Tests were administered within a single 1-hour session.
Main Results:
- High completion rates were observed for PIC and MRM tests.
- The CCT had lower feasibility, particularly in younger children (3-5 years), with success rates of 79% in patients and 87% in controls.
- Age positively influenced CCT completion odds (OR 5.63, p=0.007).
- PIC and MRM tests demonstrated high reliability, while CCT's reliability was lower.
- Color discrimination thresholds decreased with age, irrespective of visual acuity status.
Conclusions:
- Pseudoisochromatic (PIC) and Mollon-Reffin minimalist (MRM) tests are feasible and reliable for evaluating color vision in young children with reduced visual acuity.
- The Cambridge Colour Test (CCT) exhibits reduced feasibility in children aged 3-5 years, likely due to its longer duration.
- Color discrimination improves with age, a finding consistent across different visual acuity levels.
Purpose:
To investigate feasibility, reliability and discriminative validity of pseudoisochromatic (PIC) colour vision tests, the Mollon-Reffin minimalist (MRM) test and the Cambridge Colour Test (CCT) among children (3-10 years) with reduced visual acuity.
Methods:
Thirty-three patients with reduced visual acuity and 38 healthy control subjects with age-related normal visual acuity were recruited for this prospective study. Visual acuity in patients was reduced due to amblyopia, binocular maculopathy, or optic neuropathy. Tests were performed in a single 1-hr session.
Results:
All but two children successfully completed the PIC and MRM tests. Success rate for the CCT was lower, 87%, CI [72%, 96%] for control subjects and 79%, CI [61%, 91%] for patients, with a strong positive effect of age on the odds of successful completion (OR 5.63, p = 0.007). Reliability was high in PIC and MRM tests but comparably lower in CCT. The rate of correct answers in PIC tests was between 88% and 100%. One proband was diagnosed with deuteranomaly with an average Ishihara score of 21%. All children (with the exception of one daltonian) scored at least two points in the MRM test. Sensitivity thresholds in CCT decreased with age with a strong effect size in control subjects and weak to moderate effect size in patients.
Conclusions:
Pseudoisochromatic and MRM tests show sufficient feasibility in young children with reduced visual acuity. For CCT feasibility in 3-5-year olds is reduced, most probably due to the longer test duration. Consistent with earlier findings, colour discrimination thresholds decrease with age independent on visual acuity status.
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