Is vision screening in 3-year-old children feasible? Comparison between the Lea Symbol chart and the HVOT (LM) chart

Authors

  • G. Kvarnström,

    1. Department of Ophthalmology, Linköping University Hospital, Linköping, Sweden
    Search for more papers by this author
  • P. Jakobsson

    Corresponding author
    1. Department of Ophthalmology, Linköping University Hospital, Linköping, Sweden
      Peter Jakobsson
      Department of Neuroscience and Locomotion
      Division of Ophthalmology
      Linköping University
      SE-581 85 Linköping
      Sweden
      Tel: + 46 13 22 30 66
      Fax: + 46 13 22 30 65
      Email: petja@inr.liu.se
    Search for more papers by this author

Peter Jakobsson
Department of Neuroscience and Locomotion
Division of Ophthalmology
Linköping University
SE-581 85 Linköping
Sweden
Tel: + 46 13 22 30 66
Fax: + 46 13 22 30 65
Email: petja@inr.liu.se

Abstract.

Purpose: The aim of this prospective study was to compare visual screening at the age of 3 years with screening at 4 years using two different charts.

Methods: A total of 478 3-year-old children were tested at four child health care centres (CHCCs). Of these children, 440 were tested again at the age of 4 years. A third group, a control group, consisting of 229 children, was examined only at the age of 4 years. All children were tested with both the HVOT chart and the Lea Symbol chart.

Results: Testability rates for 3-year-olds were almost the same with the Lea Symbol chart and the HVOT chart (82.8% and 84.8%, respectively). The corresponding rates for the same children tested at 4 years of age were 96.5% and 97.0%, and for the 4-year-olds not previously tested 92.9% and 92.8%. The mean testing time was somewhat shorter for the Lea Symbol chart in all three groups, but the difference was not statistically significant. The difference in the assessment of visual acuity between the two charts was small and less than 1/10th of a line. The positive predictive value was lower at 3 years (58%) than has previously been found at 4 years (74.6%).

Conclusion: Three-year-old children co-operate well in visual acuity testing. However, the examination time is a little longer and the testability rate is about 10% lower than at 4 years. Both 3-year-old and 4-year-old children can be tested equally well with the HVOT and the Lea Symbol charts.

Ancillary