Comparison of visual acuity measurements via three different methods in preschool children: Lea symbols, crowded Lea symbols, Snellen E chart

İnal, Aslı; Ocak, Osman Bulut; Aygıt, Ebru Demet; Yılmaz, İhsan; Inal, Berkay; Taşkapili, Mühittin; Gökyiğit, Birsen

doi:10.1007/s10792-017-0596-1

Cited by 12 publications

(10 citation statements)

References 16 publications

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“…There are multiple methods of checking visual acuity in children in clinic: Lea symbols, Kay pictures, HOTV, Snellen letter s, Sloan letters, Early Treatment of Diabetic Retinopathy Study (ETDRS), tumbling “E”; all with and without crowding bars. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 Lea symbols, HOTV, and letter acuity have been recommended for use in children. 8 , 11 Visual Acuity is also mass-tested in vision screening programs with the goal of detecting children with visual impairment as recommended by the American Academy of Pediatrics and the American Association for Pediatric Ophthalmology and Strabismus.…”

Section: Introductionmentioning

confidence: 99%

Teleophthalmology: Evaluation of Phone-based Visual Acuity in a Pediatric Population

Silverstein

Williams

Brown

et al. 2021

American Journal of Ophthalmology

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: Purpose With the recent rise of teleophthalmology due to coronavirus disease, we are in need of accurate and reliable methods of checking visual acuity remotely. We compare the visual acuity as measured by the GoCheck Kids application, HOTV with the amblyopia treatment study (ATS), and our clinic protocol. Design This is a prospective, comparison of visual acuity assessment methods. Methods Established patients (aged 3-18) in the practice of a single pediatric ophthalmologist were eligible. Visual acuity was measured by: 1) GoCheck Kids mobile application (by patient’s family member), 2) HOTV-ATS (by study personnel), and 3) regular clinic protocol (by ophthalmic technician). To assess agreement between measures of acuity, intraclass correlations with 95% confidence intervals were computed. Results Fifty-three children participated. The mean difference between GoCheck Kids and HOTV-ATS acuities (0.094) was significantly different (p<0.001); the intraclass correlation (ICC) was 0.55 (95% CI: 0.40, 0.68). The mean difference between GoCheck Kids and chart acuities (0.010) was not significantly different (p=0.319); ICC: 0.59 (95% CI: 0.45, 0.71). The mean difference between HOTV-ATS and chart acuities (0.084) was significantly different (p<0.001); ICC: 0.66 (95% CI: 0.53, 0.76). The percent of eyes with visual acuity as measured by GoCheck Kids that was within 1 line of the HOTV-ATS and chart acuity was 65.3% and 86.7%, respectively. Conclusions GoCheck Kids as checked by a family member provides a modest correlation of visual acuity compared to the chart screen and a fair correlation of visual acuity compared to HOTV-Amblyopia Treatment Study protocol, though a vast majority are within 1 line.

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Section: Introductionmentioning

confidence: 99%

Teleophthalmology: Evaluation of Phone-based Visual Acuity in a Pediatric Population

Silverstein

Williams

Brown

et al. 2021

American Journal of Ophthalmology

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“…A lower percentage of failure in the older group, 48-59 months, can be attributed to the visual maturation process. 2 Almost every other study also found that preschool children tended to be more cooperative with Lea symbols. 1,11,14 However, a 2017 study found a 5-11% better testability rate with Tumbling E in children aged 3-4 years compared to previous studies which was hypothetically connected with stimulation of spatial orientation through a smartphone.…”

Section: Resultsmentioning

confidence: 95%

“…There are two types of charts, either using letter optotypes, such as in HOTV, Landolt C, and Tumbling E (E-chart), or using picture optotypes, as in Lea symbols. 2 The Lea symbols chart was the first logMAR-based chart that was well-accepted for pediatric visual acuity tests. It consists of three symbols (apple, square, and house) which have several crucial differing features from the fourth symbol, a circle.…”

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confidence: 99%

Visual acuity assessment of preschool children in the inner city area in Jakarta

Yulia

Laksmita

Barliana

et al. 2021

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Background Visual acuity (VA) assessment is an important ocular examination to identify children with vision problems. Such early identification allows for early intervention to prevent childhood blindness. Objective To describe and compare visual acuity measurements in preschool children using two different visual acuity charts. Methods This cross-sectional study in children aged 36-60 months was done in a low-income area in the Central Jakarta District as a collaboration between Department of Ophthalmology and Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta. All children underwent visual acuity examinations using Lea symbols and Tumbling E charts. The VA results from two charts were analyzed with Bland-Altman plot for limits of agreement. Statistical analyses were performed to determine the differences between vision charts. Results A total of 113 children enrolled, but only 38 children completed the examinations. The mean age of subjects was 50.5 (SD 6.4) months. Overall, subjects’ mean VA was 0.29 (SD 0.18) for Lea symbols and 0.37 (SD 0.14) for Tumbling E. The mean difference of VA between Lea symbols and Tumbling E was 0.07 (SD 0.22) logMAR units, with upper and lower limits of agreement at 0.36 and 0.51, respectively. There was no statistical difference in VA score using Lea symbols and Tumbling-E based on gender and age. Conclusion Most preschool children in our study have normal visual acuity. Lea symbols and Tumbling E chart are comparable and can be used to efficiently measure VA in preschool children.

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“…It was designed to avoid some cultural barriers using common pictures (square, circle, house, heart), and speech problems or shyness with the option of matching gures [5,15]. Many studies have compared LEA symbols and letter optotypes in children, most of them showing good agreement [16][17][18]. However, the question about comparison between symbols and letters is still open, because some works addressed a tendency to higher VA values when measuring with LEA [19][20], while others turn to perform on the contrary [21].…”

Section: Resultsmentioning

confidence: 99%

Comparison between different visual acuity tests and validation of a digital device

Montori

López

Alejandre³

et al. 2022

Preprint

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PURPOSETo compare different visual acuity tests (printed and digital, symbols and letters) and to validate a new device for visual acuitytesting called DIVE. METHODSVisual acuity was tested in a wide spectrum of adult people with printed tests (ETDRS and LEA symbols) and with two tests implemented in DIVE (HOTV and DIVE symbols). Results of visual acuity values were comparedwithintraclass correlation coefficient and with Bland Altman method. RESULTSRight eyes from 50 adult participants were included in the study. Correlation between tests was high (ICC from 0.93 to 0.98). Bland Altman graphics showed good agreement among the different tests, with differences within clinical reasonable limits. The maximum difference between mean values was 0.09LogMar, less than1 line of distance. However, slightly higher values were obtained with HOTV and DIVE symbols, followed by ETDRS and LEA. CONCLUSIONDIVE visual acuity assessments are reliable tests highly correlated with traditional visual acuity tests.

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Comparison of visual acuity measurements via three different methods in preschool children: Lea symbols, crowded Lea symbols, Snellen E chart

Abstract: We found SLS, CLS, and SE to be consistent: all three methods can be used to obtain measurements of VA in healthy and amblyopic preschool children.

Cited by 12 publications

References 16 publications

Teleophthalmology: Evaluation of Phone-based Visual Acuity in a Pediatric Population

Teleophthalmology: Evaluation of Phone-based Visual Acuity in a Pediatric Population

Visual acuity assessment of preschool children in the inner city area in Jakarta

Comparison between different visual acuity tests and validation of a digital device

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