Background
Methods
Search | Query | Items |
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#2 | Search (((((Infant[MeSH] OR Infant* OR infancy OR Newborn* OR Baby* OR Babies OR Neonat* OR Preterm* OR Prematur* OR Postmatur* OR Child[MeSH] OR Child* OR Schoolchild* OR School age* OR Preschool* OR Kid OR kids OR Toddler* OR Adolescent[MeSH] OR Adoles* OR Teen* OR Boy* OR Girl* OR Minors[MeSH] OR Minors* OR Puberty[MeSH] OR Pubert* OR Pubescen* OR Prepubescen* OR Pediatrics[MeSH] OR Pediatric* OR Paediatric* OR Peadiatric* OR Schools[MeSH] OR Nursery school* OR Kindergar* OR Primary school* OR Secondary school* OR Elementary school* OR High school* OR Highschool*)))) AND #1) | 275 |
#1 | Search ((((((“Vision Tests”[Mesh:NoExp]) OR (vision test[tiab] OR vision tests[tiab] OR (testing[tiab] AND vision[tiab]) OR assessment[tiab] OR chart[tiab] OR charts[tiab]))) AND ((“Visual Acuity”[Mesh]) OR ((visual[tiab] OR vision[tiab]) AND acuity[tiab])))) AND near[tiab]) | 801 |
Study selection
Population | Children with normal vision 0–13 years |
Children with low vision 0–13 years | |
Intervention | Cross sectional studies |
Observational studies | |
Comparison | Near versus distance visual acuity |
Different near visual acuity measures | |
Outcome measures | Near visual acuity |
Near and distance visual acuity |
Inclusion criteria
Data extraction and quality assessment
Statistical analysis
Results
Results of search and selection process
Description of included studies
Near visual acuity assessments in 0–3 year olds
Impact method on VA measured
Reference | Type of study | Number of participants, group (and age). | Method | Outcome |
---|---|---|---|---|
Dayton 1964 [11] | Cross sectional | n = 39 Group = NV Age = 0–8 days | Procedure: Binocular OKN + electro-oculography Range stimuli: 20/150, 20/290, 20/440 (5 mm/s) Threshold used: 50% Viewing distance: 37 cm from center % Successful: 45% | See Fig. 2. |
Mayer 1980 [12] | Cross sectional | n = 6 Group = NV Age = 6–24 months | Procedure: Binocular Operant Preferential Looking (OPL) Range stimuli: 20/5 to 20/640 (octave steps), stimuli were selected for each child 4/5 widths per child. Threshold used: 60% + 75% (psychometric curve) Viewing distance: 57 ± 3 cm from target % Successful: 100% Test duration: 45–60 minutes | See Fig. 2. |
McDonald 1985 [13] | Cross sectional | n = 8 Group = NV Age = 4w-6 months | Procedure: Binocular acuity card procedure Range stimuli: 0.4–24 cpd (octave steps) Threshold used: Finest grating that infant can see Viewing distance: 36 ± 3 cm from center % Successful: 100% Test duration: 3–5 minutes | See Fig. 2. |
Sokol 1985 [14] | Cross sectional | n = 26 Group = NV Age = 3 months | Procedure: Binocular VEP and FPL Range stimuli: 0.31,0.62,1.25, 2.5 cpd Threshold used: 55% and 70% FPL and VEP lat + amp % successful: 65% | See Fig. 2. |
Preston 1987 [15] | Cross sectional | n = 20 Group = VI Age = 2–8 months | Procedure: Mono- and binocular acuity card procedure and FPL Range stimuli: 0.2–2.0 cpd (half octave steps) Threshold used: Finest grating that infant can see Viewing distance: 33 ± 3 cm %Successful: 100% (mono- and binocular) 83% monocular FPL Test duration: 8 minutes | 10/20 subjects were identified as having subnormal acuity on at least one test (binocular, left or right eye). Acuity card procedure is validated for use in patients. |
Kohl 1988 [16] | Longitudinal study | n = 18 Group = NV Age = 12–24 months | Procedure: Mono- and binocular acuity card procedure Range stimuli: 20/25-20/3200 (octave steps) Threshold used: Finest grating that infant can see. Viewing distance: 34 cm %Successful: Mean testable 12–24 month group 79.6% lower than 90% testable for the 0–12 month old group. | See Fig. 2. |
Salomao 1995 [17] | Cross sectional | n = 646 Group = NV Age = 0–36 months | Procedure: Monocular and binocular TAC Range stimuli: 0.23–38 cpd (half-octave steps). Start card 0.44 cpd 1–6 months, 1.3 cpd 10–18 months, 2.4 cpd >20 months Threshold used: Staircase. Last card with 2 correct responses. Viewing distance: 0–6 m: 38 cm; >6 months 57 cm. % Successful: 99.3% (binocular) 96.2% (monocular) Duration: 13 min. for one binocular and two monocular measurements | See Fig. 2. |
Neu 1997 | Cross sectional | n = 210 Group = NV Age = 1–6 years | Procedure: Monocular TAC, KAC (resolution acuity) and C-test (recognition acuity) Range stimuli: TAC: 0.32–0.38c/cm (half-octave steps), KAC: 0.40–49.2 c/cm, C-test: 0.1–1.4 (decimal) Distance: TAC and KAC: 38, 55 and 84 cm; C-test: 40 cm Threshold used: TAC as above (Salomao); C-test (3/4) 75% % Successful: TAC 40% < 2y; 96% 2-4y; | See Fig. 2. C-test gives lower acuity estimates than TAC and KAC and has higher sensitivity of the C-test for detecting uncorrected refractive errors. |
Jones 2014 [19] | Cross sectional | n = 30 Group = NV Age = 2.6–12.7 months | Procedure: Binocular validation of computerized acuity card procedure using an eye tracker (ACTIVE) Range stimuli: 0.18–12.5 cpd (KIAC), ACTIVE started at 0.36 cpd and used the same staircase procedure as TIAC Distance: 38 cm (KIAC) and 84 cm (ACTIVE) Threshold used: ACTIVE 33.3% (up2-down 1 staircase) % Successful: 100% | ACTIVE acuities fell within the 90% range of TAC acuity norms. In 101 s a reliable VA could be obtained. Test-retest data showed difference of 0.04 octaves, which is very small. Larger study needed to collect norms. |
Jones 2015 [20] | Cross sectional | n = 55 Group = NV Age = 2.6–12.7 months | Procedure: Binocular ACTIVE (see above) Range stimuli: see above Threshold used: 33.3% and 70.7% | This paper stresses the importance of using a low threshold (<50%) in infants or max correct response to assess perceptual sensitivity. |
Method of choice
Near visual acuity assessments in 4–7 year olds
Reference | Type of study | Number of participants, group (and age). | Method | Outcome |
---|---|---|---|---|
Heller 1974 [25] | Observational | n = 40 Group = NV Age = 2 ½–6 years | Test: Binocular near point acuity test card Optotype spacing: 2× letter size (edge-to-edge) Distance: 33 cm Response: Verbal. | No validation against existing charts, just determination whether 20/20 acuity was achievable with the chart. This was the case. |
Ismail 1981 [32] | Cross sectional | n = 4239 Group = NV Age =5.57 years (mean) | Test: Mono- and binocular near and distance (Sheridan-Gardiner single letter test) Optotype spacing: not specified Distance: not specified. Threshold: not specified. Response: not specified. | N5 and N6* (20/20 or 20/30) were taken as normal. Children with vision of 20/40 or lower were referred. 99.2% achieved normal vision. In the 12 children with N8 or worse low vision aids were considered. |
Hohmann 1982 [31] | Cross sectional | n = 62 Group = NV Age = 6–12 years | Test: Binocular Landolt C-test Range: 0.1–1.4 (decimal acuity) Spacing: 2.6′ and 17.2′ Distance: 40 cm (and 6 m) Threshold: 88–94% Response: Verbal or matching | The majority of subjects had vision of 1.4 (decimal). Maximum acuity uncrowded optotypes at 7 years and crowded optotypes at around 10 years. |
Dowdeswell 1995 [23] | Cross sectional | n = 68 Group = NV Age = 5;2–7;6 years | Test: Monocular Bailey-Lovie chart at 0.3 and 6 m Range: 0.1–2.0 Spacing: 1× optotype size Distance: 30 cm and 6 metres Response: Not specified | See Fig. 3. |
Lovie-Kitchin 2001 [30] | Cross sectional | n = 71 Group = low vision Age = 7–18 years | Test: Binocular near text visual acuity (reading test based on the Minnesota Low Vision Reading Test) and distance visual acuity (Bailey-Lovie chart) Spacing: not specified Distance: 10 cm and 3 metres Threshold: DVA scored per letter Response: reading | Distance vision ranged from 0.10–1.28 logMAR and near text visual acuity from 0.12–1.47 logMAR (N 1.5-N24 at 10 cm). Critical print size: 0.74–1.87 logMAR (N5-N64 at 10 cm). |
Labib 2009 [29] | Cross sectional | n = 50 Group = low vision Age = 5–15 years (mean age 11 ± 2.6 y) | Test: Monocular near (Keeler’s reading chart) and distance (Landolt C) Distance: 25 cm Spacing: Not specified Response: Verbal | The near visual acuities ranged from A10 to A20, with the mean near acuity ± SD being A13.632 ± 3.17171.DVA ranged from 4/60 (0.06) to 6/24 (0.25), with mean distance visual acuity ± SD being 0.12 ± 0.12. |
Boonstra 2012 [21] | Non-randomized controlled trial | n = 21 Group = low vision Age = 3 ½–6 years | Test: Binocular LEA near chart Distance: self-chosen distance, at 40 cm and at 3 metres Spacing: 0.5 and 1.0× letter size Response: Verbal | See Fig. 4. |
Dekker 2012 [22] | Cross sectional | n = 62 Group = NV Age = 4–12 years | Test: Binocular LEA line and single at near and distance Distance: 0.3 and 3 metres Spacing: 0.5 and 1.0× letter size Response: Verbal | Distance vision crowding ratio (95% CI): 4–6y: 1.40 (0.88–2.22) 6–12: 1.31 (0.87–1.97) Near vision crowding ratio: 4–6y: 1.01 (0.55–1.86) 6–12y: 1.01 (0.72–1.42) |
Huurneman 2012 [27] | Cross sectional | n = 58/n = 75 Group = low vision/NV Age = 4–8 years | Test: Binocular C-test and LEA line at near/C-test at distance Distance: 40 cm and 5 metres (if children had acuity < 20/125 distance was reduced to 2.5 metres at distance). Spacing: C-test: 2.6 and > =30; LEA line test 0.25, 0.5 and 1.0 × letter size Threshold: 60% (3/5) Response: Verbal | See Fig. 3. |
Huurneman 2013 [28] | Non-randomized controlled trial | n = 45/n = 29 Group = low vision/NV Age = 4–9 years | Test: Binocular LEA version C-test + LEA line 50% at near; C-test Distance: 40 cm and 5 metres (viewing distance was reduced if DVA was < 20/125) Spacing: 2.6′ and ≥ 30′; 0.5× letter size Threshold: 60% (3/5) Response: Verbal | |
Huang 2014 [26] | Cross sectional | n = 150 Group = NV Age = 3–5 years | Test: Binocular near-vision chart for children 3–5 years and the Chinese standard logarithmic near vision chart Distance: 25 cm Spacing: 1× letter size Response: Verbal | See Fig. 3. |
Impact method on NVA measured
Method of choice
Near visual acuity assessments in 8–13 year olds
Type of study | Number of participants, group (and age). | Method | Outcome | |
---|---|---|---|---|
Peckham 1975 [43] | Cross sectional | N = 12772 Group = NV Age = 11 years | Test: Near vision (Sheridan Gardener test) and distance vision (Snellen chart) Distance: 25 cm and 6 m Optotype spacing: 1× letter size (edge-to-edge) Response: Verbal. | Distance vision: - Optimal vision (6/6 or better): 77.6% - Near optimal (6/9 or better): 10% - Moderate impairment (6/18-6/12): 7.1% - Severe impairment (≤6/24): 5.3% Near vision: - Optimal vision: 87.6% - Near optimal: 7% - Moderate impairment: 4% - Severe impairment:1.4% |
Cummings 1996 [37] | Cross sectional | N = 1809 Group = NV Age = 8–10 years | Test: Not specified (near and distance vision) Distance: Not specified Optotype spacing: Not specified Response: Not specified | Normal vision (6/6): 69% Myopia: 24.3% Hypermetropia:0.7% Amblyopia: 1.5% Near vision problems: 12/1809 (<1%). |
Myers 1999 [48] | Cross sectional | N = 106 Group = NV Age = 10 years | Test: ETDRS chart (near and distance) Distance: 40 cm and 4 m Optotype spacing: Not specified Response: Verbal | See Fig. 5. |
Wolffsohn 2000 [45] | Cross sectional | N = 53 Group = VI Age = 9–91 (median age 80 years) | Test: Practical near acuity card (PNAC) and Bailey-Lovie near and distance chart Distance: 25 cm (near). Distance Bailey-Lovie unspecified. Optotype spacing: default Times new roman spacing (approx. 0.1× letter size) and 1× letter size Response: Verbal. | Mean DVA was 0.91 ± 0.04 logMAR. Good correlation between distance VA and PNAC (r = 0.74). No differences between PNAC and near Bailey-Lovie chart measures (r = 0.97). |
Virgili 2004 [44] | Cross sectional | N = 116 Group = NV Age = 6–12 years | Test: Italian version MNREAD, distance vision ETDRS Distance: 40 cm, ETDRS distance not specified Optotype spacing: reading setting (approx. ×1.1 letter size) Response: Verbal. | See Fig. 5. |
Larsson 2005 [33] | Cross sectional | N = 217 Group = NV Age = 10 years | Test: LEA chart (near and distance) Distance: 40 cm and 3 m Optotype spacing: not specified Response: Verbal. | See Fig. 5. |
Hanson 2006 [39] | Cross sectional | N = 26 Group = VI Age = 10–50 years | Test: S-charts at 40 cm and 3.75 m, Bailey-Lovie at distance (6 m) and ETDRS at near (preferred working distance). Distance: 40 cm, 3.75 m and 6 m. Optotype spacing: 1× letter size Response: Verbal | No consistent differences between near and distance VA’s. |
Fabian 2013 [38] | Cross sectional | N = 66 Group = NV Age = mean age 9 years | Test: Jaeger (near) and ETDRS (distance) Distance: not specified. Optotype spacing: not specified Response: Verbal. | See Fig. 5. All children with NV had a J1* score for near vision. |
Larsson 2015 [40] | Cross sectional | N = 217 Group = NV Age = 10 years | Test: LEA test (near and distance), linear logMAR chart (distance), LEA single optotypes (3 m) Distance: 40 cm and 3 or 4 meter Optotype spacing: not specified Response: Verbal. | See Fig. 5. |
Li 2015 [41] | Cross sectional | N = 190 Group = NV Age = 10–14 years | Test: logMAR visual acuity chart Distance: 40 cm and 4 meter Optotype spacing: not specified Response: Verbal. | See Fig. 5. |