Abstract
BackgroundAssessing visual function in infants is usually challenging. Fix-and-Follow is a simple and popular method for assessing early development of visual perception in infants, currently however, there is no formal reproducible method for grading the capacity of fix-and-follow. This study was to develop and validate a new fix-and-follow grading system for assessing visual function development in preverbal children.MethodsIn this cross-sectional study, the fix-and-follow grades was evaluated in 21 consecutive preverbal children. Fixation was categorised as grade 1 if there was no response to the target and grade 2 if there was a response but only for < 3 s. Grades of 3 and 4 were assigned based capacities to (1) fix on a moving target for ≥3 s, and (2) shift fixation from one target to another. If only one of these two criteria was met, grade 3 was assigned. If both were met, grade 4 was assigned. Following was evaluated using smooth pursuit movement, where grade 1 indicated no movement, grade 2 partial movement, and grade 3 complete movement. Two ophthalmologists independently applied the grading method in all patients. Then one of two examiners repeated the examinations to investigate the intra-observer agreement of the grading system.ResultsIntra-observer agreement was excellent (Kappa coefficient = 0.823) and inter-observer agreement was good (Kappa coefficient = 0.625). All patients who exhibited abnormal ocular movement had score discrepancy between a new fix-and-following grading examination.ConclusionsThe new fix-and-follow grading scale can be applied easily in preverbal children in an office setting, and it proved reliable and reproducible.
Highlights
Assessing visual function in infants is usually challenging
In this cross-sectional study, the fix-and-follow grades was evaluated in 21 consecutive preverbal children
Both visual sensory and oculomotor functions are essential for the normal development of visual perception [1]
Summary
Assessing visual function in infants is usually challenging. Fix-and-Follow is a simple and popular method for assessing early development of visual perception in infants, currently there is no formal repro‐ducible method for grading the capacity of fix-and-follow. Fix-and-Follow is a simple and popular method for assessing early development of visual perception in infants, currently there is no formal repro‐. This study was to develop and validate a new fix-and-follow grading system for assessing visual function development in preverbal children. Both visual sensory and oculomotor functions are essential for the normal development of visual perception [1]. The ability to fix on a target and follow it is one of the principal tests that can be used as an indicator of early development of visual perception in infants, and it is a simple and popular method used by general and paediatric ophthalmologists [4]. The purpose of the current study was to test the feasibility of a new office-based fixand-follow grading system in preverbal children
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