Visual Acuity In Preschool Children Research Articles

Ocular Manifestation of the Pediatric Age Group in Almarj

Children are disproportionately affected by visual disorders like refractive errors, amblyopia, and strabismus. Early intervention and vision screening are crucial. The study aims to investigate the ocular manifestation among children of the age group 4–15 years. A cross-sectional study conducted at Marj Teaching Hospital in 2024 examined 100 children with ophthalmological conditions. The examinations included slit lamp examinations, visual acuity assessments, spherical refractive error measurements, and dilated retinal exams. The study examined children aged 4-15 years old, with 59% being male and 43% female. Diagnosis revealed a range of ocular conditions, with astigmatism being the most common at 48%. There were significant differences in visual acuity between males and females (p<0.001), particularly in left eye visual acuity without glasses. There was no significant difference in visual acuity between age groups when wearing or not wearing glasses. However, there was a trend towards better right-eye visual acuity for children aged 4-10 years compared to those aged 11-15 years (p<0.001). Refractive errors with a higher prevalence of simple astigmatism in females compared to males. High hypermetropia was only present in females, suggesting some differences in refractive errors between males and females, particularly hypermetropia. The study emphasizes the significance of regular eye examinations for detecting and addressing visual impairments, and calls for further research into factors contributing to these conditions, particularly male-female differences, to improve eye health and quality of life. we highly advocate assessing the visual acuity of preschool children in order to prevent amblyopia.

Preliminary study on the computer-based optokinetic nystagmus analyzer to detect the visual acuity of preschool children.

The purpose of this study is to examine the viability, precision, and consistency of a computer-based optokinetic nystagmus analyzer (nystagmus meter) for diagnosing eyesight in preschoolers. A total of 59 subjects who could pass the log of minimum angle of resolution (LogMAR) visual acuity chart were divided into three groups by age, 4-, 5-, and 6-year-old groups, and their visual acuity was tested with nystagmus meter. The percentage of children in each age group that could be detected by nystagmus was recorded along with the differences between these groups. The correlation between the test results from the two methods was found for each age group using the correlation coefficient method. Repeated measurements were used to assess the two visual acuity values of the measured nystagmus, and the repeatability of the two measurement techniques for different age groups was compared. The overall measurability of the visual acuity detected by nystagmus was 93.22%, and the measurability of the 4-, 5-, and 6-year-old groups was 90%, 95%, and 94.74%, respectively. There was no statistically significant difference in the measurability of subjects among all age groups (P = 1.0). The outcomes of the LogMAR visual acuity chart had a negative correlation with the visual acuity measured by the nystagmus meter. The overall correlation coefficient R value was -0.80, and the correlation coefficient R value of the 4-, 5-, and 6-year-old groups was -0.79, -0.76, and -0.87, respectively. The nystagmus meter has good feasibility, accuracy, and stability in visual acuity testing and can be used for visual acuity testing in children.

NEAR VISUAL ACUITY IN PRE-SCHOOL VISION SCREENING: A COMPARISON OF TWO CHILDREN CHARTS OPTOTYPES

Visual acuity measurement is a crucial part in an oculovisual examination. The purpose of this study was to compare near visual acuity in pre-school Children using two children charts – the Lea symbols chart and the Sheridan Gardiner chart. One hundred and fifty three (153) pre- school Children (72 males and 81 females) between the ages of 3 to 5 years (mean age 4.23 ± 0.78 years) were recruited from five randomly selected nursery schools. Near visual acuity was measured monocularly and binocularly after a pre-testing had been done. An interval 5minutes was allowed in testing using both charts. Age and sex of each child were documented. Results showed no statistically significant difference in near visual acuities using both charts (p > 0.05). Age and gender had no significant difference in the results from each chart

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

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.

Macular Structures, Optical Components, and Visual Acuity in Preschool Children after Intravitreal Bevacizumab or Laser Treatment

To investigate the macular structures, optical components, and visual acuity in preschool-aged children with a history of type I retinopathy of prematurity who underwent either intravitreal bevacizumab (IVB), laser, or a combination of treatments. Comparative interventional case series. Setting: A referred medical center in Taiwan. Eighty eyes from 42 patients (33 IVB-treated eyes from 17 children, 24 laser-treated eyes from 13 children, and 23 laser+ IVB-treated eyes from 12 children). Spectral-domain optical coherence tomography. The retinal thickness in the foveal area and the associated morphologic changes in foveal depression. Compared with the laser-treated and laser+ IVB-treated eyes, the IVB-treated eyes had less myopia and deeper anterior chamber depths but presented similar axial lengths and corneal curvatures (P= .001, P= .002, P= .95, and P= .16, respectively). The IVB-treated eyes had significantly thinner foveal, parafoveal, and perifoveal retinal thicknesses (P < .01 for all) and a higher incidence of foveal depression than the laser- or laser+ IVB-treated eyes. The macular and subfoveal choroidal thicknesses did not differ among the groups (P= .21 and P= .63, respectively). Moreover, compared with the eyes treated with laser or laser+ IVB, the IVB-treated eyes had better uncorrected visual acuity, although a significant difference was not observed in best-corrected visual acuity (P= .008 and P= .29, respectively). Compared with laser therapy, IVB-treated eyes were associated with deeper anterior chamber depths and thinner foveal, parafoveal, and perifoveal thicknesses. Moreover, these IVB-treated eyes had fewer refractive errors and better uncorrected visual acuity.

Prevalence and causes of reduced visual acuity among children aged three to six years in a metropolis in China.

To determine the prevalence and possible causes for reduced visual acuity (VA) in preschool children in a metropolis in China. A school-based paediatric eye survey including 5862 preschool children aged three to 6 years was conducted from 2011 to 2012 in Yuhuatai District, Nanjing, China, using an age-stratified random sampling procedure. Clinical examinations including ocular alignment, ocular motility, visual acuity, prism cover test, cycloplegic refraction, stereopsis screening, slit lamp examination and fundus examination were performed by trained study ophthalmologists and optometrists. Reduced VA was defined as presenting VA of worse than 0.30 logMAR (Snellen 6/12 or 20/40), for both better and worse eyes. 5667 (94.8%) children with complete VA data were included in the data analyses. Among them, 208 and 93 had reduced VA in the worse and better eye, respectively. Reduced VA was detected in 3.7% (95% confidence interval [CI] 3.2%-4.2%) in the worse eye and 1.6% (95% CI 1.3%-2.0%) in the better eye. No significant age and gender differences in reduced VA were observed (p > 0.05). Refractive errors and amblyopia were the principal causes for reduced VA in the worse eye which accounted for 66.8% and 32.7% of the total cases with reduced VA, respectively. Astigmatism and hyperopia were the major types of refractive errors causing reduced VA. The burden of reduced VA in preschool children in China was similar to that of Asian children of similar ages in the United States. Uncorrected refractive error and amblyopia were the principal causes for reduced VA among preschoolers (aged three to 6 years) in China.

Comparing visual acuity in preschool children using the Lea symbols and Sheridan Gardiner charts

Visual acuity measurement is a vital part of an optometric examination. The purpose of the present study was to compare visual acuity in preschool children using two charts – the Lea symbols chart and the Sheridan Gardiner chart. One hundred and fifty-three preschool children (72 boys and 81 girls) between the ages of 3 and 5 years (mean age and standard deviation 4.23 ± 0.78 years) were recruited from five randomly selected nursery schools. Distance visual acuity was measured monocularly and binocularly after a pre-test was done. An interval of 5 minutes was allowed for testing with both charts. The ages and sexes of each child were documented. Results showed a statistical difference in visual acuities using both charts (p &lt; 0.05). There was also a statistical difference in both charts regarding age. There was no significant gender difference between the results from each chart.

Symbolic Number Abilities Predict Later Approximate Number System Acuity in Preschool Children

An ongoing debate in research on numerical cognition concerns the extent to which the approximate number system and symbolic number knowledge influence each other during development. The current study aims at establishing the direction of the developmental association between these two kinds of abilities at an early age. Fifty-seven children of 3–4 years performed two assessments at 7 months interval. In each assessment, children's precision in discriminating numerosities as well as their capacity to manipulate number words and Arabic digits was measured. By comparing relationships between pairs of measures across the two time points, we were able to assess the predictive direction of the link. Our data indicate that both cardinality proficiency and symbolic number knowledge predict later accuracy in numerosity comparison whereas the reverse links are not significant. The present findings are the first to provide longitudinal evidence that the early acquisition of symbolic numbers is an important precursor in the developmental refinement of the approximate number representation system.

Risk Factors for Decreased Visual Acuity in Preschool Children: The Multi-Ethnic Pediatric Eye Disease and Baltimore Pediatric Eye Disease Studies

To investigate risk factors associated with unilateral or bilateral decreased visual acuity (VA) in preschool children. Population-based, cross-sectional prevalence study. Population-based samples of 6504 children ages 30 to 72 months from California and Maryland. Participants were preschool African-American, Hispanic, and non-Hispanic white children from Los Angeles, California, and Baltimore, Maryland. Data were obtained by a parental interview and a detailed ocular examination. Logistic regression models were used to evaluate the independent associations between demographic, behavioral, and clinical risk factors with unilateral and bilateral decreased VA. Odds ratios (ORs) for various risk factors associated with interocular difference (IOD) in VA of ≥2 lines with ≤20/32 in the worse eye, or bilateral decreased VA <20/40 or <20/50 if <48 months of age. In multivariate logistic regression analysis, 2-line IOD with a VA of ≤20/32 was independently associated with Hispanic ethnicity (OR, 2.05), esotropia (OR, 8.98), spherical equivalent (SE) anisometropia (ORs ranging between 1.5 and 39.7 for SE anisometropia ranging between 0.50 to <1.00 diopters [D] and ≥2.00 D), and aniso-astigmatism in J0 or J45 (ORs ranging between 1.4 and ≥5.3 for J0 or J45 differences ranging between 0.25 to <0.50 D and ≥1.00 D). Bilateral decreased VA was independently associated with lack of health insurance (OR, 2.9), lower primary caregiver education (OR, 1.7), astigmatism (OR, 2.3 and 17.6 for astigmatism 1.00 to <2.00 D and ≥2.00 D), and SE hyperopia ≥4.00 D (OR, 10.8). Anisometropia and esotropia are risk factors for IOD in VA. Astigmatism and high hyperopia are risk factors for bilateral decreased VA. Guidelines for the screening and management of decreased VA in preschool children should be considered in light of these risk associations. The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Development of visual acuity in preschool children as measured with Landolt C and Tumbling E charts

To investigate the visual acuity development as measured by Landolt C and Tumbling E charts ("C chart" and "E chart") in preschool children. Visual acuity measurements of healthy children ages 3-6 years who had been evaluated with the use of E charts (during kindergarten screening) and C charts (in a hospital setting) from 2005 to 2007 were studied. Inclusion criteria were hyperopia <4.5 D, myopia <3.0 D, astigmatism <2.0 D, and anisometropia <2.0 D. The best-corrected visual acuity (BCVA) in each group was analyzed. There were 821 children in the E chart group and 212 in the C chart group (mean age, 5 years). The mean BCVA improved from between age 3-4 years and age 5-6 years in both groups (P < 0.001). Children in the C chart group had significantly greater astigmatism compared with those in the E chart group (0.66 D ± 0.47 vs 0.28 D ± 0.39; P < 0.001). The BCVA obtained by E chart was greater than that obtained by C chart at age 3-4 years (logMAR 0.0246 ± 0.0646 vs 0.1158 ± 0.1462, P < 0.001), but not at age 5-6 years. When children reach 5-6 years of age, visual acuity values obtained by C and E charts approach those observed in adults. In younger patients, the E chart obtains a greater visual acuity score than the C chart. Thus, thresholds for normal visual acuity in preschool children ages 3-6 years should be both age specific and test specific.

Lack of Concordance between Fixation Preference and HOTV Optotype Visual Acuity in Preschool Children: The Baltimore Pediatric Eye Disease Study

To compare the results of fixation preference testing and standardized visual acuity testing in white and black children aged 30 through 71 months. Cross-sectional study. The Baltimore Pediatric Eye Disease Study is a population-based evaluation of the prevalence of vision disorders in children aged 6 through 71 months in Baltimore, Maryland, United States. A total 1714 children 30 through 71 months of age were eligible for inclusion in this report, with 1435 (83.7%) testable by both fixation preference and Amblyopia Treatment Study (ATS) visual acuity testing protocol. The vision of all children 30 through 71 months of age was tested using both the ATS visual acuity testing protocol (using single HOTV symbols with surround bars) and fixation preference testing (FPT). The ability of fixation preference testing to identify children with clinically important interocular differences (IOD) in visual acuity (i.e., two or more logarithm of minimum angle of resolution units of difference or more). Fifty-three children had 2 or more lines of IOD in visual acuity. Seven of them were graded as having momentary or no fixation (sensitivity = 13.2%; 95% confidence interval [CI], 5.3-27.2]), whereas 45 were graded as normal by FPT. In all 7 of the cases of poor FPT, the better-seeing eye was preferred. Low sensitivity and high specificity for detecting an IOD of 2 lines or more with FPT were seen for both white (33.3% sensitivity; 95% CI, 9.5-57.2; 99.6% specificity; 95% CI, 98.7-100) and black (6.5% sensitivity; 95% CI, 0.6, 23.2; 99.3% specificity; 95% CI, 98.3-99.8) children. When assessing FPT performance for 3 or more lines of IOD, only 5 of the 20 children (sensitivity, 25%; 95% CI, 6.0-44.0) had FPT grades of momentary or no fixation. Fixation preference testing, when used as part of a population-based research project, does not identify accurately preschool children with 2 lines or more of IOD in presenting visual acuity. The clinical value of this test is poor and its use for diagnosis and monitoring interventions should be reconsidered.

Developmental Demands for Successful Measurement of Visual Acuity in Pre-School Children

Adequate application of the Lea symbol and BUST visual acuity tests (Hyvarinen et al, 1980 Acta Ophthalmologica58 507; Lindstedt, 1986 British Journal of Visual Impairment4 49), designed for children over 18 months of developmental age, in young and/or handicapped pre-school children require preliminary assessment of their level of development. To assess the developmental demands more precisely, 162 children aged from 15 to 35 months and 54 older pre-schoolers, most with normal vision, were examined. Nearly half of the children showed some developmental delays in physical and mental capabilities as assessed on the CDI scale (Ireton, 1992, Child Developmental Inventory, Behavior Science System Inc). Nevertheless, in 77% far and/or near visual acuity was successfully measured by combinations of Lea symbol and/or BUST tests. The youngest successful children, 18 and 20 months of age, passed BUST-N and Lea-Domino. For children aged 18 – 24, 24 – 29, 30 – 35 months, and 36 months and above the success rates were, respectively, 39%, 75%, 89%, and 96%. The minimal values of the CDI scale indexes among the successful children may be regarded, in addition to chronological age, as minimal developmental demands, ie conditions necessary, although not always sufficient, for the child to pass visual acuity measurements. These values in months were 16 (‘social’), 18 (‘selfserving’), 14 (‘gross motor’), 16 (‘fine motor’), 16 (‘speech development’) and 19 (‘language comprehension’). The value of the last index was the most critical. Since the developmental demands are not very high, there are good prospects of using Lea symbol and BUST tests in young and/or handicapped children.

Monocular acuity in preschool children: Assessment with the Teller and Keeler acuity cards in comparison to the C-test

The development of monocular grating acuity was studied in 210 children between 1 and 6 years using Teller Acuity Cards (TAC). 95 of these children were also tested with the Keeler Acuity Cards (KAC).Monocular visual acuity measured with the TAC showed a gradual increase from 8.4 to 32.4 c/deg for 7 to 79 month-olds and with the KAC from 14.5 to 31.4 c/deg for 19 to 78 month-olds. Mean visual acuity at 6 years was still 0.5–1.0 octave lower than grating acuity in adults.The results of 95 children tested with TAC and KAC did not indicate any significant differences between the acuity scores obtained with the two tests. Stimulus configuration of the TAC did not result in overestimation of acuity in children 1–6 years of age.In 141 older children (39–79 months), the TAC test was compared with a recognition test (C-test). Children between 3 and 5 years of age reached significantly lower acuities with the C-test than with the TAC. The C-test showed a higher sensitivity for unconnected refractive errors than the acuity card tests.

Testing kinaesthetic acuity in preschool children

Attempts to describe the kinaesthetic development of young children have been limited by the use of tasks winch are designed for older children and inappropriate for testing those of preschool age. A task designed specifically to test kinaesthetic acuity in preschool aged children was developed, and the performance of a 3- to 4-year-old group compared with that of a 5- to 6-year-old group. The task involved a passive hand movement to 1 of 16 positions with the hand hidden from the child's view, the child identifying the position to which their hand had been moved by a verbal response (naming the animal pictured at mat location). The results indicated that children as young as 3 years of age have considerable kinaesthetic sensitivity, and that by 5 to 6 years the ability to utilise kinaesthetic cues to identify hand position is very good. The older group performed significantly better than the younger group. A sex difference in kinaesthetic acuity at 3 to 4 years of age was also revealed, with boys of this age performing more accurately than girls. This difference was not evident in children of 5 to 6 years of age.

Measurement of letter acuity in preschool children

Measurement of visual acuity remains the most frequently used technique for the assessment of vision in both adults and children. Visual acuity is usually measured clinically in adults using a Snellen chart. However. this technique demands a level of cognition and literacy which is beyond the majority of young children. The measurement of visual acuity in preschool children presents an additional set of problems but it is important that measures of acuity arc made with sufficient precision and accuracy to provide the clinician with valid information. While visual acuity can be measured in infants and very young children using behavioural and clectrophysiological techniques, clinical measurement of letter acuity usually commences when the child is old enough to interact and co-operate with the examiner. By 3 years of age 67% of children will cooperate with visual acuity testing, and by the age of 3.5 years a level of 80% compliance is achieved. The need to detect and correct visual disorder5 during childhood has been recognized for many years by eye-care professionals. Although identification of reduced visual function due to ametropia is important, the detection and treatment of amblyopia is essential

Measurement of letter acuity in preschool children

Ophthalmic and Physiological OpticsVolume 15, Issue s1 p. S11-S17 Measurement of letter acuity in preschool children Paul V. McGraw, Paul V. McGraw Department of Vision Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK *MBCOSearch for more papers by this authorBarry Winn, Barry Winn Department of Optometry, University of Bradford, Richmond Road, Bradford, West Yorkshire BD7 1DP, UK *MBCOSearch for more papers by this author Paul V. McGraw, Paul V. McGraw Department of Vision Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK *MBCOSearch for more papers by this authorBarry Winn, Barry Winn Department of Optometry, University of Bradford, Richmond Road, Bradford, West Yorkshire BD7 1DP, UK *MBCOSearch for more papers by this author First published: March 1995 https://doi.org/10.1046/j.1475-1313.1995.0150s1S11.xCitations: 2 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume15, Issues1March 1995Pages S11-S17 RelatedInformation

Glasgow Acuity Cards: a new test for the measurement of letter acuity in children.

Problems with design and format of the traditional Snellen chart have led to the development of alternative charts for the measurement of visual acuity in adults. However, advances in chart design for the measurement of visual acuity in pre-school children have not paralleled those used in adult test charts. Visual acuity can be measured in infants and very young children using behavioural and electrophysiological techniques but clinical measurement of letter acuity tends to commence when the child is old enough to interact and co-operate with the examiner. Charts which are commercially available in the UK for measuring letter acuity in pre-school children (3-5 years old) either use single optotypes or are derivatives of the Snellen format. There is a need for a test of letter acuity for use with this young age group which is accurate, reliable and based upon sound and established design principles. Glasgow Acuity Cards have been designed to include features that should allow change in letter acuity to be detected in pre-school children, especially those undergoing vision therapy training. The test is performed at 3 m and incorporates several design features which have been used previously in adult charts but are new to childrens' test charts. These include: linear progression of letter sizes using a log scale; letters of approximately equal legibility; equal number of letters per line; control of contour interaction; screening cards to determine initial level of acuity. The test is quick and easy to perform and should provide a means of detecting change in letter acuity, with increased confidence.

New visual acuity test for pre-school children.

A new test chart was developed for the measurement of visual acuity of pre-school children. The symbols of the test are circle, square, apple and house. These were so designed that each symbol measures visual acuity similarly. This feature of the test was verified experimentally. The visual acuity values measured by the individual symbols correlated highly with the visual acuity values measured with the whole test (0.82-0.86). The correlation between the visual acuity values measured repeatedly, the reliability of the new test, was found to be 0.94 for adult subjects. The new visual acuity test thus fulfils the statistical criteria of a good visual acuity test. Because both children and nurses seem to like the new test, it may be useful in the assessment of visual acuity in pre-school children.

Visual acuity in preschool children: a new picture-test.

Visual acuity in preschool children: a new picture-test.

Assessment of visual acuity in preschool children.

Abstract.— Problems in testing visual acuity of preschool children were discussed with regard to choice of optotype and test distance, illumination, instruction and response indicator, and the motivational aspect of the test situation. A test situation conforming to these requirements for measuring visual acuity was arranged for testing of preschool children, using a discrimination learning paradigm with simultaneous presentation of the cues. The test figures were two Landolt Cs of equal size but one with the gap filled in, thus forming a circle. Small toys were used as rewards for choosing the Landolt C. Of 27 children, 2–6 years of age, 25 achieved a visual acuity level corresponding to a Snellen value of 20/20. The results thus indicate a better visual acuity for preschool children than is commonly believed.