Pediatric Visual Acuity Testing

Visual acuity measurement is an essential component of any eye exam. In adults and older children, letter-based acuity (i.e., recognition acuity) is commonly used to measure vision. However, in infants and toddlers, performing traditional visual acuity testing is nearly impossible. Instead, modified optotypes such as gratings and pictures are shown to observe the young child's visual behavior. Additionally, there are objective visual acuity methods that negate the need for observing visual behavior. For the practicing clinician, the choices are many and can be confusing. With new commercial products coming into the market every day, it is nearly impossible to comprehensively cover each one of them. Instead, in this chapter, commonly used and/or studied visual acuity tests are covered. For each test, the set-up, procedure, documentation, and scientific evidence supporting or negating its use are discussed.