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Psychometric Performance of Children With Amblyopia During a Tablet-Based Adaptive Visual Acuity Assessment.

Jan Skerswetat^1,2, Zain Ahmed³, Nikhil Chaudhry³

¹Department of Psychology, Northeastern University, Boston, Massachusetts, United States.

Investigative Ophthalmology & Visual Science

|July 6, 2026

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A new self-administered near visual acuity (VA) test, AIM-VA, effectively detects amblyopia in children. This adaptive test shows good repeatability and may help manage amblyopia.

Area of Science:

Ophthalmology
Pediatric Optometry
Visual Science

Background:

Visual acuity is crucial for diagnosing amblyopia (lazy eye).
Current tests may require specialized administration.
Objective and repeatable visual acuity measurements are needed for children.

Purpose of the Study:

To introduce and evaluate a self-administered near visual acuity (VA) test, the Angular Indication Measurement paradigm (AIM-VA).
To assess AIM-VA's performance in children with and without amblyopia.
To compare AIM-VA's repeatability and agreement with the standard Snellen-VA test.

Main Methods:

Thirty-five children (5-16 years) with and without amblyopia completed AIM-VA twice and a Snellen-VA test.
AIM-VA used adaptive Landolt-C optotypes with varying sizes and gap orientations.

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Data analyzed using psychometric modeling and Bland-Altman analysis for repeatability and agreement.

Main Results:

AIM-VA detected significant interocular acuity differences (IOD) in children with amblyopia, similar to Snellen-VA.
The one-parameter AIM-VA model demonstrated good test-retest repeatability with no significant bias.
Exploratory analysis suggested psychometric parameters may indicate functional deficits and differentiate amblyopia subtypes.

Conclusions:

AIM-VA is a viable self-administered tool for assessing near visual acuity in children.
The test successfully identified amblyopic visual deficits and showed good repeatability.
AIM-VA holds potential for amblyopia management and further research into subtype phenotyping.