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Vision testing of young children in the age range 18 months to 4 1/2 years
Insights
This study found that children aged 30 months can cooperate with letter-matching vision tests using plastic letters, and all children aged 18 months to 4 1/2 years can complete vision tests at 20 feet.
Area of Science:
- Ophthalmology
- Pediatric Vision Screening
Background:
- Accurate vision screening in young children is crucial for early detection of visual impairments.
- Traditional letter-matching tests often require a certain cognitive and cooperative ability that develops with age.
Purpose of the Study:
- To determine the age at which children cooperate with letter-matching vision tests using a key card.
- To assess if using plastic letters instead of a key card improves test accessibility at younger ages.
- To evaluate the feasibility of 20-foot (6-meter) vision testing and patch occlusion acceptance in this age group.
Main Methods:
- A cohort of 425 normal children aged 18 months to 4 1/2 years participated.
- Children were tested using a letter-matching vision test with a key card and with plastic letters.
- Testing was conducted at a 20-foot (6-meter) distance, and acceptance of patch occlusion was recorded.
Main Results:
- Cooperation with key card letter-matching tests began effectively at 33 months of age.
- Using plastic letters lowered the achievable age to 30 months, with a 25% increase in cooperation up to 39 months.
- All children successfully completed the 20-foot (6-meter) vision test.
- The period around a child's second birthday presented the greatest challenge for patch occlusion acceptance.
Conclusions:
- Plastic letters facilitate earlier cooperation in letter-matching vision screening compared to key cards.
- Vision testing at 20 feet (6 meters) is feasible for children from 18 months to 4 1/2 years.
- Age around 24 months is the most challenging for occlusion, requiring specific strategies.
Abstract:
Four hundred and twenty-five normal children in the age range 18 months to 4 1/2 years have been studied to determine the percentage of children according to age who can be expected to cooperate in a letter-matching vision test using a key card; to see whether the use of plastic letters to replace the key card lowers the age at which a letter-matching test can be achieved, and to show that children in this age range can do a vision test at 20ft (6m). Acceptance of occlusion using a patch occluder was also examined. The study shows that children effectively begin to cooperate in letter-matching vision tests using a key card from 33 months of age. Replacement of the key card with plastic letters lowers the age to 30 months and thereafter there is a gain of some 25% of children up to 39 months. All children were successfully tested at 20ft (6m). The most difficult age for occlusion was in the age group around the second birthday.