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Comparison of the HOTV and Lea Symbols charts for preschool vision screening
Insights
The Lea Symbol chart and HOTV chart showed similar preschool vision screening results overall. However, the Lea Symbol chart demonstrated better testability rates for 3-year-old children.
Area of Science:
- Ophthalmology
- Pediatric Vision Screening
- Optometry
Background:
- Preschool vision screening is crucial for early detection of visual impairments.
- Standardized charts are essential for reliable and efficient vision testing in young children.
- Comparing different visual acuity charts informs best practices in pediatric eye care.
Purpose of the Study:
- To prospectively compare the Lea Symbol chart and the HOTV chart in a preschool vision screening program.
- To evaluate test time, reliability, and testability rates for each chart.
- To determine the efficacy of each chart for different age groups within the preschool population.
Main Methods:
- Seven hundred seventy-seven children aged 3-5 years were randomized into screening sequences.
- Each child underwent screening on two occasions within a 6-week period.
- Testing was conducted at 10 feet without isolating optotypes.
Main Results:
- Test time was not significantly related to the chart used but decreased with age.
- Reliability coefficients were comparable between the Lea Symbols and HOTV charts.
- Testability rates improved with age; Lea Symbols showed higher testability in 3-year-olds (92% vs. 85%).
Conclusions:
- Both charts are acceptable for preschool vision screening, with faster and more frequent success in older children (4-5 years).
- The Lea Symbols chart may be more efficacious for screening 3-year-old children due to higher testability rates.
- The choice of chart can impact screening success, particularly for the youngest participants.
Purpose:
Two preliterate acuity charts, the Lea Symbol chart and the HOTV chart, were compared prospectively in an established preschool vision screening program. The charts were compared by measuring time required to test, reliability coefficients, and the percentage of children testable with each chart.
Methods And Materials:
Seven hundred and seventy-seven 3- to 5-year-old children were randomized to four screening sequences that determined the order of chart use. Each child was screened on two occasions within 6 weeks. Testing was performed at 10 feet, and optotypes were not isolated for testing.
Results:
Mean test time was significantly less for older children, but was not related to the chart used. Reliability coefficients were similar for the Lea Symbols and the HOTV charts. The percentage of children testable by each chart improved with increased age of the child. More 3 year olds were testable with the Lea Symbols chart compared to the HOTV chart (92% versus 85%, P = .05).
Conclusions:
Vision screening with either chart was more rapid and more frequently achieved with 4- and 5-year-old children compared with the 3 year olds. For the population as a whole, each chart gave similar results. Among the 3 year olds, however, testability rates were better for the Lea Symbols chart. The Lea Symbols chart is an acceptable option for preschool vision screening, and may be more efficacious than the HOTV chart for screening 3-year-old children.