Vision Test for Young Children Called Unreliable

Researchers found standard way of measuring acuity in preschoolers missed problems

By Steven Reinberg
HealthDay Reporter

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FRIDAY, Oct. 3 (HealthDay News) -- The standard test for checking the vision of young children cannot be completely trusted, Johns Hopkins University researchers report.

The test, called fixation preference test (FPT), is used to evaluate visual acuity, which is the ability of the eyes to focus images on the macula, the part of the eye that handles detailed vision.

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"Current methods of testing vision in very young children need to be re-assessed," said lead researcher Dr. David S. Friedman, an associate professor of ophthalmology and international health at Johns Hopkins Wilmer Eye Institute.

The report was published in the October issue of Ophthalmology.

For the study, Friedman's team evaluated visual acuity in 1,504 children aged 30 to 71 months. The researchers used a series of tests including FPT and the Amblyopia Treatment Study test (ATS).

For the FPT, each eye is covered and then uncovered, which determines how well the eyes maintain fixation. The test is designed to measure visual acuity in the best eye. The purpose of the ATS test is to measure visual acuity in children aged 30 months and older.

The researchers found that the FPT, which is considered the standard for testing vision in young children and the only test available to most eye specialists, did not accurately identify problems in visual acuity.

The inaccuracy of the FPT was apparent, when the researchers compared test results between FPT and ATS among children who were able to take both tests.

Dr. Sandra Block, a professor of optometry at the Illinois College of Optometry in Chicago, isn't surprised that the FPT isn't foolproof.

"What we want to find out in children that are preschool age is a decrease in vision due to amblyopia such as nearsightedness, farsightedness or a significant astigmatism, which leads to 'lazy eye,'" Block said. "One test that looks at visual acuity in the good seeing eye does not give a full picture. We may be missing some of the amblyopia."

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