Testing of Visual Acuity in Young Children: an Evaluation of Some Commonly Used Methods

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Abstract
In a comparative study of screening tests for visual acuity in young children, 2 groups of children were presented with 3 different tests. In the younger group (3-5 yr) 3 single opto-type tests were compared: Sheridan''s 5 and 7 letter matching test, the Fooks test and the E card test. The Sheridan test gave the best results and the E card test was unsuitable for this age group. The Fooks was an attractive test but was less sensitive in the detection of defects than the Sheridan test. In the older group (5-7 yr) a single opto-type test, the Sheridan-Gardiner test, was compared with the E chart and Snellen chart. The Sheridan-Gardiner test had limitations in the detection of defects, including amblyopia, therefore results obtained by this method should not be considered to be directly comparable with those of the Snellen chart. The E chart gave good results in the detection of defects and there was less lateral confusion than expected. It has disadvantages, but there is still a place for its use in the screening of normal school-age children. The Snellen chart was the most effective test in the detection of defects, but not all the children were able to cooperate in its use. Where possible, the Snellen chart should always be the method of choice.