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Can children measure their own vision? A comparison of three new contrast sensitivity tests
Michael D Crossland1,2, Tessa M Dekker1,2, Annegret Dahlmann-Noor1,2
1NIHR Moorfields Biomedical Research Centre, London, UK.
Insights
Children can accurately measure their own contrast sensitivity using tablet or paper tests. Most preferred a gamified tablet test, with high willingness for home use, indicating feasibility for vision monitoring.
Area of Science:
- Ophthalmology
- Pediatric Vision
- Digital Health
Background:
- Contrast sensitivity is crucial for visual function.
- Assessing contrast sensitivity in children often requires clinical supervision.
- Developing self-administered tests can improve accessibility and monitoring.
Purpose of the Study:
- To evaluate the feasibility of children self-administering contrast sensitivity tests.
- To compare tablet-based (Manifold, PopCSF) and paper-based (Spotchecks) tests.
- To assess repeatability, duration, and participant preference for these tests.
Main Methods:
- Forty children (aged 5-15) with amblyopia, vision impairment, or good vision performed three self-administered tests (Manifold, PopCSF, Spotchecks).
- Key metrics included completion rate, test-retest repeatability, duration, and participant preference.
- Correlation with clinical visual acuity and contrast sensitivity was analyzed.
Main Results:
- All tested children (36/40) completed the tests.
- All tests showed significant correlation with clinical measures (p < 0.001).
- Spotchecks demonstrated the highest repeatability (0.13 dB), while PopCSF was the quickest (130s) and most preferred (22/40 participants).
Conclusions:
- Children can reliably self-measure contrast sensitivity using accessible tests.
- The PopCSF test is a preferred and efficient option for pediatric contrast sensitivity assessment.
- High willingness (98%) suggests potential for regular home-based vision monitoring.
Purpose:
To investigate the feasibility of children measuring their own contrast sensitivity using a range of tablet- and paper-based tests.
Methods:
Forty children aged 5-15 years with amblyopia (N = 10), bilateral vision impairment (N = 10) or good vision (N = 20) measured their own vision on a screen-based optotype test (Manifold), a gamified vision test (PopCSF) and a paper-based test (Spotchecks) in a laboratory with minimal supervision. Completion rate, test-retest repeatability, test duration and participants' preferences were recorded for each test.
Results:
Most participants (36/40) were able to perform all three tests. All tests were correlated with clinically measured visual acuity and contrast sensitivity (p < 0.001). The 95% coefficient of repeatability was 0.30 dB for Manifold, 0.29 dB for PopCSF and 0.13 dB for Spotchecks. All tests differentiated between children with reduced contrast sensitivity and control participants. PopCSF and Spotchecks were also able to differentiate between children with amblyopia and those with good vision. Median test time was 152, 130 and 202 s for Manifold, PopCSF and Spotchecks, respectively. Twenty-two participants preferred the PopCSF test, 10 preferred Spotchecks and 6 preferred Manifold. Thirty-nine out of the 40 children (98%) said they would measure their own vision at home using at least one of these tests every month.
Conclusions:
Children and young people can test their own contrast sensitivity with repeatable results. Of these three tests, the most repeatable was Spotchecks, the quickest was PopCSF and participants' favourite was PopCSF. Nearly all of the participants said they would be willing to use at least one of the three tests at home.
