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Related Experiment Video

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Author Spotlight: An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
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An office-based fix-and-follow grading system assessing visual function in preverbal children.

Hyeshin Jeon1,2, Jae Ho Jung3, Hee-Young Choi4,5

  • 1Department of Ophthalmology, School of Medicine, Pusan National University, 1-10 Ami-dong Seo-gu, Busan, 49241, South Korea.

BMC Ophthalmology
|December 1, 2021
PubMed
Summary

A new grading system for assessing infant visual function using the Fix-and-Follow method was developed. This reliable and reproducible scale is easy to use in clinical settings for preverbal children.

Keywords:
Fix-and-followSaccadeVisual developmentVisual screening

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Area of Science:

  • Ophthalmology
  • Pediatric Vision Assessment

Background:

  • Assessing visual function in infants presents challenges.
  • The Fix-and-Follow method is commonly used but lacks a standardized grading system.
  • A reproducible method is needed to evaluate visual development in preverbal children.

Purpose of the Study:

  • To develop and validate a novel grading system for the Fix-and-Follow method.
  • To assess visual function development in preverbal children.
  • To establish a reproducible and reliable tool for clinical use.

Main Methods:

  • A cross-sectional study evaluated the new grading system in 21 preverbal children.
  • Fixation was graded based on response duration and ability to shift gaze.
  • Following was assessed by smooth pursuit eye movements.
  • Two ophthalmologists independently applied the grading system, with repeat testing for intra-observer agreement.

Main Results:

  • The grading system demonstrated excellent intra-observer agreement (Kappa = 0.823) and good inter-observer agreement (Kappa = 0.625).
  • Discrepancies in scores were noted in patients with abnormal ocular movements.
  • The system proved effective in differentiating visual function capacities.

Conclusions:

  • The developed Fix-and-Follow grading scale is easily applicable in pediatric office settings.
  • The scale is reliable and reproducible for assessing visual function in preverbal children.
  • This tool enhances the objective evaluation of early visual development.