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Assessing visual function in children younger than 1 1/2 years with normal and subnormal vision: evaluation of
1Department of Ophthalmology, Karolinska Institute, Huddinge University Hospital, Sweden.
Insights
Early detection of vision problems in infants is crucial. Current tests for visual acuity in children under 1 1/2 years old are unreliable for diagnosing visual impairment or strabismus.
Area of Science:
- Ophthalmology
- Pediatric Vision Assessment
Background:
- Early detection of subnormal vision is critical for timely intervention and rehabilitation in infants.
- Current diagnostic methods for visual acuity in very young children are limited.
Purpose of the Study:
- To evaluate the effectiveness of specific visual assessment tools in differentiating normal vision from visual impairment or strabismus in infants.
- To identify reliable methods for early diagnosis of vision disorders in children under 1 1/2 years of age.
Main Methods:
- Forty-six infants (1 month to 1 1/2 years) were tested using Stycar rolling balls, preferential looking (Teller acuity cards), and detection of small objects (raisins, puffed rice, sugar strands) on contrasting backgrounds.
- Participants included infants with assumed normal vision, diagnosed visual impairment, or strabismus.
Main Results:
- Infants with visual impairment or strabismus frequently exhibited age-appropriate results, masking underlying conditions.
- Infants with assumed normal vision sometimes scored below expected norms on Stycar rolling balls and Teller acuity cards.
- The tested methods showed limited ability to reliably distinguish between normal vision, visual impairment, and strabismus in this age group.
Conclusions:
- The evaluated tests (Stycar rolling balls, Teller acuity cards) are not sufficiently reliable for differentiating normal vision, visual impairment, or strabismus in children younger than 1 1/2 years.
- Reliable diagnosis requires tests assessing recognition acuity, symbols, or letters, which are typically feasible in older children.
- Despite limitations, these tests can provide a general estimate of visual function in infants.
Purpose:
Methods for detecting subnormal vision early in life are needed to adequately diagnose the condition and begin treatment and rehabilitation.
Methods:
Forty-six children ages 1 month to 1 1/2 years with either assumed normal vision, visual impairment due to eye disease, or strabismus were examined with the following tests: Stycar rolling balls; preferential looking (Teller acuity cards); and the ability to detect raisins, puffed rice, and sugar strands on two different backgrounds, one white and one black.
Results:
Children with visual impairment and strabismus often showed normal values for their age, and children with assumed normal vision sometimes had values below those established for normal development of vision with the Stycar rolling balls and the Teller acuity cards.
Conclusions:
It is not possible to use these tests to reliably differentiate among normal vision, visual impairment, or strabismus in children younger than 1 1/2. Not until recognition acuity, symbols, or letters can be tested can reliable results be obtained. However, the tests are useful to estimate the general visual function of children in this age group.