Comparison of current paediatric contrast sensitivity assessments using simulated reduced contrast thresholds

Area of Science:

• Ophthalmology
• Visual Science
• Clinical Measurement

Background:

• Contrast sensitivity (CS) testing in children is limited.
• The Hiding Heidi (HH) test has a ceiling effect.
• The Double Happy (DH) test's ability to detect contrast changes is not well-established.

Purpose of the Study:

• Compare contrast thresholds and agreement between the HH and DH tests.
• Evaluate these tests against the Pelli Robson (PR) chart.
• Assess performance under normal, dim, and reduced visual clarity conditions.

Main Methods:

• 50 adult participants (age 18-62) were tested.
• Contrast sensitivity was measured uniocularly using PR, HH, and DH tests.
• Testing was conducted under bright (20,900 lux) and dim (2,000 lux) light, with and without simulation spectacles.

Main Results:

• 94% of participants reached the maximum score on the HH test, compared to 18% on the DH test.
• The reduction in CS under dim conditions was -0.21 logCS units for PR and DH, but only -0.04 logCS for HH.
• The DH test demonstrated better agreement with the PR chart than the HH test.

Conclusions:

• The DH test is superior to the HH test in detecting changes in contrast sensitivity.
• DH shows better agreement with the established PR chart.
• DH is recommended for clinical practice due to its improved performance and sensitivity.