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      A Novel Computerized Visual Acuity Test for Children

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          Abstract

          Purpose

          To investigate the efficacy of a computerized visual acuity test, the SNU visual acuity test for children.

          Methods

          Fifty-six children, ranging from 1 to 5 years of age, were included. In a dark room, children gazed at and followed a circular dot with 50% contrast moving at a fixed velocity of 10 pixels/sec on a computer monitor. Eye movement was captured using a charge coupled device camera and was expressed as coordinates on a graph. Movements of the eye and dot were superimposed on a graph and analyzed. Minimum visualized dot diameters were compared to the Teller visual acuity.

          Results

          Ten eyes (8.9%) of six children failed to perform the Teller visual acuity test, and two eyes (1.8%) of one patient failed to perform the SNU visual acuity test. The observed Teller visual acuity and SNU visual acuity were significantly correlated ( p < 0.001). Visual angle degrees converted from the Teller visual acuity and SNU visual acuity were also significantly correlated ( p < 0.001).

          Conclusion

          The SNU visual acuity using moving targets correlated well with Teller visual acuity and was more applicable than the Teller acuity test. Therefore, the SNU visual acuity test has potential clinical applications for children.

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          Most cited references21

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          Human-computer interaction using eye-gaze input

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            Abnormal spatial selection and tracking in children with amblyopia.

            We assessed 18 children with unilateral amblyopia and 30 age-matched controls on one low-level and three high-level motion tasks. Children with amblyopia showed similar performance to controls in both amblyopic and fellow eyes on a low-level global motion task and on a high-level 2-dot apparent motion task. Performance on both single-object and multiple-object attentive tracking tasks was significantly depressed in both amblyopic and fellow eyes relative to controls. These findings suggest that binocular regions of posterior parietal cortex likely contribute to a deficit in voluntary, spatial attention that is a component of amblyopia.
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              Grating visual acuity with Teller cards compared with Snellen visual acuity in literate patients.

              To determine the usefulness of Teller Acuity Cards for detecting three levels of vision deficit, the cutoff for amblyopia (20/40 or poorer), vision impairment (20/70), or legal blindness (20/200). We compared grating visual acuity with the Teller cards with Snellen visual acuity (our gold standard) in 69 literate patients with amblyopia or other cause of vision loss in a prospective masked study. Teller card visual acuity and distance Snellen visual acuity correlated significantly (r = .508, P < .001); however, Teller card visual acuity explained only 26% of the variation in distance Snellen visual acuity. Teller card visual acuity had a low sensitivity for detecting vision deficit of 20/40 or poorer (58%), vision deficit of 20/70 or poorer (39%), or legal blindness (24%), but somewhat more accurately reflected near Snellen visual acuity than distance visual Snellen acuity. Teller cards had a higher positive predictive value--80% for 20/70 visual acuity and 43% for legal blindness, as determined by near Snellen visual acuity. Specificity of Teller cards was 88% for detecting visual acuity loss of 20/70 and 98% for legal blindness. Negative predictive value of Teller cards for detecting visual acuity loss of 20/70 was 50% and for legal blindness was 71%. Teller Acuity Cards may underestimate the presence of amblyopia of all types, legal blindness, and a specified level of vision impairment (20/70). Even in the presence of normal visual acuity measurements with Teller cards, significant visual loss as assessed by standard Snellen optotypes may be anticipated in many patients.
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                Author and article information

                Journal
                Korean J Ophthalmol
                Korean J Ophthalmol
                KJO
                Korean Journal of Ophthalmology : KJO
                The Korean Ophthalmological Society
                1011-8942
                2092-9382
                June 2013
                30 April 2013
                : 27
                : 3
                : 194-198
                Affiliations
                [1 ]Department of Ophthalmology, Hallym University College of Medicine, Chuncheon, Korea.
                [2 ]Department of Biomechanics, Seoul National University College of Medicine, Seoul, Korea.
                [3 ]Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
                Author notes
                Corresponding Author: Jeong-Min Hwang, MD. Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, #82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 463-707, Korea. Tel: 82-31-787-7379, Fax: 82-31-787-4057, hjm@ 123456snu.ac.kr
                Article
                10.3341/kjo.2013.27.3.194
                3663062
                23730112
                354a0509-b70a-4413-870f-617ef29f5f19
                © 2013 The Korean Ophthalmological Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 March 2012
                : 18 July 2012
                Categories
                Original Article

                Ophthalmology & Optometry
                child,snu dot visual acuity test,teller visual acuity test,visual acuity test,visual angle

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