presented by dr. arvind kumar (g.r.m.c., gwalior, m.p.)

1. VARIOUS METHODS OF
MEASUREMENT OF VISUAL
ACUITY IN CHILDREN
Dr. Arvind kumar
Resident second year
Department of ophthalmology

2. Assessment of visual acuity from birth to 3
months
BLINK REFLEX TEST
*Present since birth
*light - blink
PUPILLARY LIGHT REFLEX TEST
*In semidarkened room.
*Indicates intact afferent
and efferent visual pathways.
*most reliable test to determine presence
of vision except in cortical blindness.

3. VESTIBULO-OCULAR REFLEX(VOR)
*Doll’s eye response (eye deviate
opposite direction of head
position).
EYE POPPING TEST
*Room lights are suddenly
dimmed -upper lid pop open
*Lights are brought up back—close lid

4. OPTOKINETIC NYSTAGMUS(OKN) TEST
*Nystagmus elicited.
*The visual angle subtended by smallest
strip width that still elicits eye movement
(minimum separable) is a measure of V.A.
*OKN acuity: 6/120 (newborn)
6/60 (at 2 mnth)
6/30 (at 6 mnth)
6/6 (by 20-30 mnth)
*Resolution acuity.

5. • VISUAL EVOKED RESPONSE(VER):
*EEG recording.
*Only clinically objective technq. available
to asses functional state of visual system
beyond retinal ganglion cells.
a) Flash VER
b) pattern VER:
*visual stimulus-checkerboard.
VER ACUITY: 6/120 (1 mnth)
6/60 (2 mnth)
6/6 (1 yr)

6. Assessment of V.A. from 3 to 6 months
FIXATION
BEHAVIOUR TEST

7. CENTRAL,STEADY,MAINTAINED(CSM)
METHOD
Central: corneal light reflex
Steady: with thumb sized toy
Maintained: ability to keep eye fixed
when either eye is covered
Results – CSM: 6/9 to 6/6
Central study not maintained
(CSNM): 6/36 to 6/60
Unsteady central fixation:<6/60

8. BRUCKNER’S RED REFLEX TEST
*Red reflex by direct ophthalmoscope
*Whitening of red reflex- strabismus,
anisometropic amblyopia.

9. Menace reflex test
*Reflex closure of eyes on the approach of an object.
*Present after age of 5 mnths.

10. Assessment of V.A. from 6 to 12 months
Preferential looking test (PLT)
*Teller acuity card test(TAC)
*V.A. 6/240 (new born)
6/60 (3 mnths)
6/6 (36 mnths)
*Resolution acuity.

11. CATFORD DRUM TEST
*Oscillating drum
Black dots size 0.5 to 15mm
Vision b/w 6/6 to 2/60
*Detection acuity.

12. Assessment of V.A. from 1 to 3 years
CARDIFF ACUITY CARDS TEST(CAC)
*Vanishing optotype test.
*Recognition + Resolution acuity.

13. MARBLE GAME TEST
SHERIDAN’S BALL TEST
Worth ivory ball test
Dot visual acuity test
Coin test
Miniature toy test

14. Assessment of visual acuity in preschool
children(3-5 yrs.)
1.Landolt‘s C test
2.Broken wheel test
3.Illiterate E-cutout test 1 2
4.Tumbling E-pad test
5.Isolated hand figure test
4

15. 6.Sheridan –gardiner HOTV test
7.Pictorial vision charts
A. Allen cards test
B. Kay picture test
C. Lea symbols test
A
A
B C

16. 8.BOEK CANDY BEAD TEST
*Match beads at 40cm
*Snellen V.A. equivalent of 20/200
9.LIGHT HOME PICTURE CARDS TEST
*Snellen’equivalent of 20/200-20/10

17. Thank u…