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Related Experiment Video

Updated: Jul 26, 2025

Author Spotlight: An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
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Children's visual acuity tests without professional supervision: a prospective repeated measures study.

Daniel Osborne1,2, Aimee Steele3, Megan Evans4

  • 1University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK. d.osborne@soton.ac.uk.

Eye (London, England)
|June 16, 2023
PubMed
Summary

Home visual acuity tests for children show potential but require improvement. Unsupervised parent-led tests were less accurate than clinical measures, indicating a need for better training or support for home-based vision assessments.

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Area of Science:

  • Ophthalmology
  • Pediatric Vision Care
  • Digital Health

Background:

  • Home visual acuity tests can reduce the burden on ophthalmic services.
  • They offer potential for remote patient monitoring and frequent vision outcome updates during therapy.
  • These tests may also identify vision problems in asymptomatic individuals and engage patients in their treatment.

Purpose of the Study:

  • To evaluate the accuracy of a tablet-based visual acuity test (iSight Test Pro) administered by unsupervised parents/carers compared to clinical standard measures in children.
  • To compare the iSight Test Pro when used by orthoptists versus parents/carers against standard clinical protocols.

Main Methods:

  • A study involving 42 children aged 3.3 to 9.3 years attending outpatient clinics.
  • Visual acuity was measured three times: by a registered orthoptist (clinical protocol), by an orthoptist using the iSight Test Pro, and by an unsupervised parent/carer using the iSight Test Pro.

Main Results:

  • Parent/carer-led iSight Test Pro measurements (median 0.300 logMAR) were significantly different from standard clinical measures (median 0.155 logMAR) (P=0.008).
  • Orthoptist-led iSight Test Pro measurements (median 0.180 logMAR) showed no significant difference from standard clinical measures (P=0.289).
  • There was no significant difference between orthoptist-led iSight Test Pro and parent/carer-led iSight Test Pro measurements (P=0.108).

Conclusions:

  • Unsupervised home-based visual acuity measurements using this technique are not comparable to clinical standards for children.
  • The findings suggest this method is unlikely to be valuable for clinical decision-making in its current form.
  • Future research should focus on enhancing test accuracy through improved training, equipment, software, or supervision.