ABSTRACT
Preschool age(3-6 years old)is a critical period for visual development, and it is crucial to detect and treat visual problems in preschool children as early as possible. Visual acuity charts are important tools for screening visual issues in children. In China, the commonly used charts are the standard logarithmic visual acuity chart and the pediatric optotype chart, while overseas, the Lea, HOTV, and ETDRS visual acuity charts are frequently employed. Numerous studies have reported the measurability, repeatability, and sensitivity of these three charts in diagnosing visual-related problems in children. However, the application of these three charts is relatively limited in China. This article provides a comprehensive review of the design principles, clinical applications, and characteristics of these three visual acuity charts, so as to better understand their applicability and limitations in preschool children, and provide reference for the selection and improvement of vision examination methods in the future.
ABSTRACT
AlM:To evaluate the applicability and the development of the normal visual acuity from age 3 to 3. 5 years using Lea Symbols and HOTV charts. METHODS:lt was a survey research study. Totally, 133 preschoolers ( 266 eyes ) between 3 to 4. 5 years old recruited from two kid-gardens in Guangzhou were tested with both the Lea Symbols chart and the HOTV chart. Outcome measures were monocular logarithm of the minimum angle of resolution ( logMAR) visual acuity and inter-eye acuity difference in logMAR units for each test. RESULTS: The testability rates of the two charts were high (96. 24% vs 92. 48%, respectively), but difference was not statistically significant (P>0. 05). The difference between the two kind of monocular vision was not statistically significant (the right eye: t=0. 517, P=0. 606;the left eye: t = - 0. 618, P = 0. 538 ). There was no significant difference between different eye ( Lea Symbols chart:t=0. 638, P=0. 525; HOTV chart: t= -0. 897, P=0. 372). The visual acuities of the boys were better than those of the girls, but the difference was not statistically significant (P>0. 05). The results which came from visual acuities with the two charts for the corresponding age groups (3-year-old group, 3. 5-year-old group, 4-year-old group, 4. 5-year-old group) indicated that the visual acuities of the preschoolers were improving with increasing age, but the difference among the visual acuities with the Lea Symbols chart was not statistically significant (the right eye:F=2. 662, P=0. 052;the left eye:F=1. 850, P=0. 143). However the difference among the visual acuities with the HOTV chart was statistically significant (the right eye:F=4. 518, P=0. 005;the left eye:F=3. 893, P=0. 011). CONCLUSlON: Both Lea Symbols and HOTV chars are accepted and appropriate for preschool vision screening from 3 to 4. 5 years old. The monocular visual acuity of preschoolers from age 3 to 4. 5 years could be assessed was similar using the two charts. There is no correlation between visual acuity and different eye. There is no statistical difference between the genders. The results further demonstrate that the preschoolers whose age reached three years old have the ability to accept the Subjective vision checks. Also the development of the normal visual acuity is faster in the early stage.
ABSTRACT
La medición de la agudeza visual en niños representa un importante reto para el optómetra por ser laboriosa y requerir conocimiento y paciencia. Según el estímulo, la agudeza visual puede dividirse en tres tipos: de detección, de resolución y de reconocimiento. Los valores de estas pueden ser diferentes y se alteran en diferente proporción en presencia de problemas visuales. El presente artículo hace una revisión de los tests de agudeza visual para niños, sobre los que se han realizado gran número de investigaciones en los últimos años: Teller, Cardiff, Lea, HOTV y las cartillas logMAR que podrían emplearse en el grupo de escolares.Conclusiones: las pruebas contempladas en esta revisión no son necesariamente las más utilizadoas en nuestra práctica clínica cotidiana; sin embargo, la actividad investigativa en torno a éstas ha aportado a la construcción de protocolos diagnósticos. El referente para una mejor práctica clínica debe ser la optometría basada en la evidencia, ya que ésta permite a los profesionales disponer de nuevos elementos de juicio objetivos, con fundamento científico, que contribuyan a la elección de la mejor alternativa para determinar la agudeza visual en los niños. El optómetra debe seguir rigurosamente los protocolos de evaluación de la agudeza visual para dar a sus mediciones mayor confiabilidad y analizar los resultados obtenidos dentro del contexto de la historia clínica. Los métodos para la evaluación de la agudeza visual pueden adaptarse de acuerdo con las habilidades, el conocimiento y la experiencia del niño que va a examinarse. Con esta revisión se evidencia la importancia de realizar estudios sobre la aplicación de estos tests en nuestro medio con el fin de evaluar su confiabilidad y utilidad en nuestros pacientes.
The visual acuity measurement in children is an important Challenger for the optometrist, given de complexity of the task and to require knowledge and patience. According to the stimulus, the visual acuity can be divided in three types: detection, resolution and recognition. The values of these can be different and they are altered in different proportion in the presence of visual problems. The present article makes an overhaul of the test of the visual acuity for children which years have generated great number of investigations in the past years: Teller, Cardiff, Lea, HOTV and logMAR charts that could be used in the school age group.Conclusions: The tests reviewed are not necessarily used commonly used our clinical daily practice, nevertheless the investigative activity concerning these has reached in the construction of diagnostic protocols. The reference for a better clinical practice must be the optometry based on the evidence, since this one allows to the professionals to have new facts that contribute to the election of the best alternative to determine the visual acuity in the children. The optometrist a must follow rigorously the protocols of evaluation of the visual acuity to give to measurements major reliability and to analyze the results obtained inside the context of the history. The methods for the evaluation of the visual acuity can be adapted in agreement with the skills, knowledge and experience of the child being examinated. There is evident the importance of realizing studies on the application of these test in order to evaluate their reliability and utility in our patients
Subject(s)
Aptitude Tests , Pediatrics , Visual AcuityABSTRACT
We assessed the best method for preschool vision screening using four visual acuity charts. The subjects were 162 childrens(324 eyes), who were divided into all aged group(162 childrens), 3-year-old group(58 childrens), 4-year-old group(58 childrens) and 5-year-old group(46 childrens), We compared Hahn's test, HOTV test, Allen figures and E test by measuring the time required for test, the percentage of children testable with each chart, visual acuity score and consistency of score. There was no significant differences among the time of each group(p>0.05). Visual acuity score with Hahn's test was lower than that of the rest 3 tests in all aged group and 3-year-old group(p<0.05). The percentage of children testable with Hahn's test was lower than that with the other tests(p<0.05). For assessing the consistency, analysis of variance was used. E test was more variable than the other test and Allen figures showed most consistency than the other tests(p<0.05). In young chidren, there were some difficulties in measuring visual acuity with Hahn's test, and the E test caused variable results because of difficulty in distinguishing the left-right orientation, but relatively Allen figures showed consistency, high visual acuity and testability in all groups.