Vidya Muraleedharan, Lavanya G Rao
Vision assessment in preschoolers is chal-lenging tasks, especially in children with developmen-tal delay (DD), in whom vision problems usually gounnoticed, further worsening their cognitive impair-ment. The purpose of this study was to find a reliable,accurate and feasible method of visual acuity assess-ment, between Cardiff Acuity Card (CAC) and Leasymbol (LS) tests, in preschool-children with andwithout DD and/or amblyogenic risk.
The Prospective Observational Studyenrolled 90 children aged 2–5 years, categorized intothree groups [1.with DD, 2.with amblyogenic risk,3.normal controls]. All subjects underwent visionassessment by LS and CAC, followed by complete oph-thalmic examination, conducted by single examinerunder same test conditions, and acuity scores wererecorded in LogMAR units. The cooperation level andtime taken were also analysed.
Vision impairment was 10–20 times more inchildren with DD or amblyogenic risk as compared tonormals, highlighting need for vision testing in thesehigh risk groups. Vision estimates by LS and CACshowed excellent correlation, except in children withDD, in whom CAC over-estimated by 0.2LogMAR.Amblyopia detection rate based on inter-eye acuitydifference was comparable between LS and CAC tests.CAC was completed quicker.
Though LS is a reliable, standardizedtest for vision assessment in preschoolers CAC is morechild-friendly, less time consuming, with better test-ability (especially in cognitively impaired) and compa-rable visual acuity scores as that of LS. Interocularacuity difference of ?0.2 LogMAR using either of thetests, in presence of an amblyogenic factor, warrantsdetailed evaluation.