Assessment of Grating Acuity in Infants and Toddlers Using an Electronic Acuity Card: The Dobson Card

Purpose: To determine if testing binocular visual acuity in infants and toddlers using the Acuity Card Procedure (ACP) with electronic grating stimuli yields clinically useful data. Methods: Participants were infants and toddlers ages 5 to 36.7 months referred by pediatricians due to failed automate...

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Bibliographic Details
Published in:	Journal of pediatric ophthalmology and strabismus Vol. 53; no. 1; pp. 56 - 59
Main Authors:	Kathleen M. Mohan, Joseph M. Miller, Erin M. Harvey, Kimberly D. Gerhart, Howard P. Apple, Deborah Apple, Jordana M. Smith, Amy L. Davis, Tina Leonard-Green, Irene Campus, Leslie K. Dennis
Format:	Journal Article
Language:	English
Published:	United States SLACK INCORPORATED 01-01-2016
Subjects:	Babies Child, Preschool Children & youth Female Humans Infant Male Mydriatics - administration & dosage Ophthalmology Refractive Errors - diagnosis Refractive Errors - physiopathology Retinoscopy Vision Tests - instrumentation Vision, Binocular - physiology Visual Acuity - physiology
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Summary:	Purpose: To determine if testing binocular visual acuity in infants and toddlers using the Acuity Card Procedure (ACP) with electronic grating stimuli yields clinically useful data. Methods: Participants were infants and toddlers ages 5 to 36.7 months referred by pediatricians due to failed automated vision screening. The ACP was used to test binocular grating acuity. Stimuli were presented on the Dobson Card. The Dobson Card consists of a handheld matte-black plexiglass frame with two flush-mounted tablet computers and is similar in size and form to commercially available printed grating acuity testing stimuli (Teller Acuity Cards II [TACII]; Stereo Optical, Inc., Chicago, IL). On each trial, one tablet displayed a square-wave grating and the other displayed a luminance-matched uniform gray patch. Stimuli were roughly equivalent to the stimuli available in the printed TACII stimuli. After acuity testing, each child received a cycloplegic eye examination. Based on cycloplegic retinoscopy, patients were categorized as having high or low refractive error per American Association for Pediatric Ophthalmology and Strabismus vision screening referral criteria. Mean acuities for high and low refractive error groups were compared using analysis of covariance, controlling for age. Results: Mean visual acuity was significantly poorer in children with high refractive error than in those with low refractive error (Mean visual acuity was significantly poorer in children with high refractive error than in those with low refractive error ( P = .015). Conclusions: Electronic stimuli presented using the ACP can yield clinically useful measurements of grating acuity in infants and toddlers. Further research is needed to determine the optimal conditions and procedures for obtaining accurate and clinically useful automated measurements of visual acuity in infants and toddlers. [[ J Pediatr Ophthalmol Strabismus . 2016;53(1):56–59.]
ISSN:	0191-3913 1938-2405
DOI:	10.3928/01913913-20160113-09