Testing visual acuity of young children: An evidence-based guide for optometrists
28 November 2010
Volume 11, Issue 4
This article provides practical advice for optometrists and other eye care professionals managing paediatric patients.
Introduction
When testing young children in optometric practice, clinicians rely on the visual acuity measurement to rule out amblyopia and to identify improvements in visual acuity with treatment. However, it is important in this context that the tests applied are robust in order that measures of acuity are as accurate as possible. This article provides practical advice for optometrists and other eye care professionals managing paediatric patients. Using the evidence available in the scientific literature and her own clinical and research experience, the author discusses the options available for testing paediatric visual acuity in a clinical setting. She compares some of the tests available (including the Cardiff acuity test, the crowded Lea symbols, the logMAR crowded test, the crowded Kay picture test and the Sonksen logMAR chart) and evaluates the evidence base for the robustness of some commonly used visual acuity tests. Data relating to normative values for visual acuity at different ages and guidelines for what constitutes a significant interocular acuity difference are provided.
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Related further reading
The College is urging parents to begin taking their children to see an optometrist before school age, especially if they or their parents require glasses with a strong prescription or there is any family history of eye problems.
Kaye McIntosh on managing patients with nystagmus in the consulting room – patience is key in examinations.
Becky McCall analyses the evidence that working distance increases the risk of myopia in children, and the escalation of time spent on screens is related to the surging incidence of myopia around the world.