Visual acuity is routinely referred to as a gold standard of vision screening (eg, Silbert et al. 2014 http://www.ncbi.nlm.nih.gov/pubmed/24372416). However there are a variety of visual acuity tests available, some not adequately validated or with other problems. The following list reviews current acuity tests.
While electronic versions of visual acuity tests are widely used (see Section 9. Automated and Semi-Automated Sensory Tests), the cost-effectiveness of acuity based on card or plastic stock. is significant for many settings.
1. Sonksen logMAR Test
Salt AT, Wade AM, Proffitt R, Heavens S, Sonksen PM. The Sonksen logMAR Test of Visual Acuity: I. Testability and reliability. J AAPOS. 2007; 11(6):589-596. Epub 2007 Jul 27. http://www.ncbi.nlm.nih.gov/pubmed/17681815
2. Sonksen logMAR Test
Sonksen PM, Wade AM, Proffitt R, Heavens S, Salt AT. The Sonksen logMAR test of visual acuity: II. Age norms from 2 years 9 months to 8 years. J AAPOS. 2008; 12(1):18-22. Epub 2007 Jul 24. http://www.ncbi.nlm.nih.gov/pubmed/17651997
3. logMAR Crowded test, Sonksen logMAR test, Crowded Kay Picture test
Norgett Y, Siderov J. Crowding in children's visual acuity tests--effect of test design and age. Optom Vis Sci. 2011 Aug;88(8):920-927. doi:10.1097/OPX.0b013e31821bd2d3. http://www.ncbi.nlm.nih.gov/pubmed/21532515
4. Keeler LogMAR crowded test, Crowded Kay Picture test
Little JA, Molloy J, Saunders KJ.The differing impact of induced astigmatic blur on crowded and uncrowded paediatric visual acuity chart results. Ophthalmic Physiol Opt. 2012; 32(6):492-500. doi: 10.1111/j.1475-1313.2012.00939.x. Epub 2012 Sep 26. http://www.ncbi.nlm.nih.gov/pubmed/23009274
5. Keeler LogMAR crowded test, Crowded Kay Picture test
Little JA, Molloy J, Saunders KJ. The differing impact of induced astigmatic blur on crowded and uncrowded paediatric visual acuity chart results. Ophthalmic Physiol Opt. 2012; 32(6):492-500. doi: 10.1111/j.1475-1313.2012.00939.x. Epub 2012 Sep 26. http://www.ncbi.nlm.nih.gov/pubmed/23009274
6. Crowded Kay Picture Test
Shah N, Laidlaw DA, Rashid S, Hysi P. Validation of printed and computerised crowded Kay picture logMAR tests against gold standard ETDRS acuity test chart measurements in adult and amblyopic paediatric subjects. Eye (Lond). 2012; 26(4):593-600. doi: 10.1038/eye.2011.333. Epub 2011 Dec 23. http://www.ncbi.nlm.nih.gov/pubmed/22193878
7. logMAR Kay picture test, logMAR acuity test
Elliott MC, Firth AY. The logMAR Kay picture test and the logMAR acuity test: a comparative study. Eye (Lond). 2009; 23(1):85-88. Epub 2007 Sep 28.
8. Kay Picture Test, logMAR Crowded Test
Jones D, Westall C, Averbeck K, Abdolell M. Visual acuity assessment: a comparison of two tests for measuring children's vision. Ophthalmic Physiol Opt. 2003 Nov;23(6):541-6. http://www.ncbi.nlm.nih.gov/pubmed/14622358
9. HOTV, Lea
Ruttum MS, Dahlgren M. Comparison of the HOTV and Lea symbols visual acuity tests in patients with amblyopia. J Pediatr Ophthalmol Strabismus. 2006 May-Jun;43(3):157-160. http://www.ncbi.nlm.nih.gov/pubmed/16761636
10. HOTV, Lea
Cyert L, Schmidt P, Maguire M, Moore B, Dobson V, Quinn G; Vision in Preschoolers (VIP) Study Group. Threshold visual acuity testing of preschool children using the crowded HOTV and Lea Symbols acuity tests. J AAPOS. 2003; 7(6):396-399.
11. HOTV, Lea
Vision in Preschoolers Study Group. Preschool visual acuity screening with HOTV and Lea symbols: testability and between-test agreement. Optom Vis Sci. 2004; 81(9):678-683. http://www.ncbi.nlm.nih.gov/pubmed/15365387
12. Patti Pics
Silbert DI, Matta NS, Brubaker A. Flip chart Visual Acuity Screening for Amblyopia Risk Factors Compared to the PlusoptiX A09 Photoscreener,Tests Performed by a Lay screener. Binocul Vis Strabolog Q Simms Romano. 2013;28(4):222-228. http://www.ncbi.nlm.nih.gov/pubmed/24372416
13. Patti Pics, Lea
Mercer ME, Drover JR, Penney KJ, Courage ML, Adams RJ. Comparison of Patti Pics and Lea Symbols optotypes in children and adults. Optom Vis Sci. 2013; 90(3):236-241. doi: 0.1097/OPX.0b013e3182825eb7. http://www.ncbi.nlm.nih.gov/pubmed/?term=patti+pics
14. No crowding specified except “A line of figures is preferred over single figures”
Committee on Practice and Ambulatory Medicine Section on Ophthalmology; American Association of Certified Orthoptists; American Association for Pediatric Ophthalmology and Strabismus; American Academy of Ophthalmology. Eye examination in infants, children, and young adults by pediatricians: organizational principles to guide and define the child health care system and/or improve the health of all children. Ophthalmology. 2003; 110(4):860-865. http://www.ncbi.nlm.nih.gov/pubmed/12689914
15. LeaLinear, HOTV
Ying GS, Kulp MT, Maguire M, Ciner E, Cyert L, Schmidt P; Vision in Preschoolers Study Group. Sensitivity of screening tests for detecting vision in preschoolers-targeted vision disorders when specificity is 94%. Optom Vis Sci. 2005; 82(5):432-438. http://www.ncbi.nlm.nih.gov/pubmed/15894920
16. Lea linear, HOTV
Schmidt P, Maguire M, Dobson V, Quinn G, Ciner E, Cyert L, Kulp MT, Moore B, Orel-Bixler D, Redford M, Ying GS; Vision in Preschoolers Study Group. Comparison of preschool vision screening tests as administered by licensed eye care professionals in the Vision In Preschoolers Study. Ophthalmology. 2004 ;111(4):637-650. http://www.ncbi.nlm.nih.gov/pubmed/15051194
17. Lea Single
Vision in Preschoolers Study Group. Preschool vision screening tests administered by nurse screeners compared with lay screeners in the vision in preschoolers study. Invest Ophthalmol Vis Sci. 2005; 46(8):2639-2648. http://www.ncbi.nlm.nih.gov/pubmed/16043831
18. Not Specified
AAPOS Vision Screening Recommendations http://www.aapos.org/terms/conditions/13
19. Not Specified
Joint Policy Statement. Vision Screening for Infants and Children. A joint statement of the American Association for Pediatric Ophthalmology and Strabismus and the American Academy of Ophthalmology.
20. Linear Lea, Single Lea
Maguire MG; Vision in Preschoolers Study Group. Children unable to perform screening tests in vision in preschoolers study: proportion with ocular conditions and impact on measures of test accuracy. Invest Ophthalmol Vis Sci. 2007; 48(1):83-87. http://www.ncbi.nlm.nih.gov/pubmed/17197520
21. Linear HOTV, Linear Lea
Vision in Preschoolers Study Group. Preschool visual acuity screening with HOTV and Lea symbols: testability and between-test agreement. Optom Vis Sci. 2004 ; 81(9):678-683. http://www.ncbi.nlm.nih.gov/pubmed/15365387
22. Linear HOTV, Linear Lea
Vision in Preschoolers (VIP) Study Group. Effect of age using Lea Symbols or HOTV for preschool vision screening. Optom Vis Sci. 2010; 87(2):87-95. doi: 10.1097/OPX.0b013e3181c750b1. http://www.ncbi.nlm.nih.gov/pubmed/19996814
23. Bailey-Lovie E chart, Lea chart
Sanker N, Dhirani S, Bhakat P. Comparison of visual acuity results in preschool children with Lea symbols and Bailey-Lovie E chart. Middle East Afr J Ophthalmol. 2013; 20(4):345-348. doi: 10.4103/0974-9233.120020. http://www.ncbi.nlm.nih.gov/pubmed/24339687
24. HOTV Linear, Lea linear
Vision in Preschoolers Study Group. Preschool visual acuity screening with HOTV and Lea symbols: testability and between-test agreement. Optom Vis Sci. 2004; 81(9):678-683. http://www.ncbi.nlm.nih.gov/pubmed/15365387
25. Lea Chart, Bailey-Lovie Chart
Dobson V, Maguire M, Orel-Bixler D, Quinn G, Ying GS; Vision in Preschoolers (VIP) Study Group.Visual acuity results in school-aged children and adults: Lea Symbols chart versus Bailey-Lovie chart. Optom Vis Sci. 2003; 80(9):650-654. http://www.ncbi.nlm.nih.gov/pubmed/14502046
26. Kay pictures, LogMAR
Elliott MC, Firth AY. The logMAR Kay picture test and the logMAR acuity test: a comparative study. Eye (Lond). 2009; 23(1):85-88. Epub 2007 Sep 28. http://www.ncbi.nlm.nih.gov/pubmed/17901881
27. Glasgow Acuity Cards (= LogMar Acuity Test )
Simmers AJ, Gray LS, Spowart K. Screening for amblyopia: a comparison of paediatric letter tests. Br J Ophthalmol. 1997; 81(6):465-469. http://bjo.bmj.com/content/81/6/465.full.pdf+html
28. Glasgow Acuity Cards (= LogMar Acuity Test)
McGraw PV, Winn B, Gray LS, Elliott DB. Improving the reliability of visual acuity measures in young children. Ophthalmic Physiol Opt. 2000; 20(3):173-184. http://www.ncbi.nlm.nih.gov/pubmed/10897339
29. Crowded linear Kay Pictures, crowded linear Lea Symbols, crowded linear Keeler logMAR and multiple line HOTV
Nicola Anstice, Samantha Watkins, Melissa Thomson, Benjamin Thompson, Robert J. Jacobs, Andrew Collins.
Comparison of visual acuity across pediatric tests
From: ARVO Meeting 2014
Program Number: 439 Poster Board Number: D0058
Presentation Time: 8:30 AM–10:15 AM
Go to following and scroll down: http://www.arvo.org/webs/am2014/abstract/sessions/114.pdf.
30. Acuity test design
Song S, Levi DM, Pelli DG. A double dissociation of the acuity and crowding limits to letter identification, and the promise of improved visual screening. J Vis. 2014; 14(5). pii: 3. doi: 10.1167/14.5.3. http://www.ncbi.nlm.nih.gov/pubmed/24799622.
31. Crowded Lea Chartt
Chen SI, Chandna A, Norcia AM, Pettet M, Stone D. The repeatability of best corrected acuity in normal and amblyopic children 4 to 12 years of age. Invest Ophthalmol Vis Sci. 2006;47(2):614-619. http://www.ncbi.nlm.nih.gov/pubmed/16431958.