The Cardiff acuity test used for measuring visual acuity development in toddlers

doi:10.1016/0042-6989(94)90168-6

Vision Research

Volume 34, Issue 4, February 1994, Pages 555-560

https://doi.org/10.1016/0042-6989(94)90168-6 Get rights and content

Abstract

The Cardiff acuity test was used in estimating the binocular and monocular visual acuity norms of 231 toddlers between 12 and 36 months. Mean binocular acuity increased from 4.5 to 1.2 min arc and monocular acuity from 4.5 to 1.4 min arc over the age range. Interocular acuity difference was not significant and for 99% of the children, the difference in acuity estimate was ⩽ 1/3 octave. Success rates ranged from 96 to 100% for binocular tests but fell to a range of 41–91% for monocular testing. Acuity assessment was fast and the intraobserver reliability was high. Age norms of visual acuity useful in clinical settings are presented for toddlers between the ages of 12 and 36 months.

Reference (12)

BirchE.E.
Infant interocular acuity differences and binocular vision
Vision Research
(1985)
BirchE.E. et al.
Visual acuity and its meridional variations in children aged 7–60 months
Vision Research
(1983)
MayerD.L. et al.
Visual acuity development in infants and young children, as assessed by operant preferential looking
Vision Research
(1982)
McDonaldM.A.
Assessment of visual acuity in toddlers
Survey of Ophthalmology
(1986)
AdohT.O. et al.
The Cardiff Test: A new visual acuity test for toddlers and children with intellectual impairment. A preliminary report
Optometry and Visual Science
(1992)
AtkinsonJ. et al.
Contrast sensitivity function of preschool children
British Journal of Ophthalmology
(1981)

There are more references available in the full text version of this article.

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The Cardiff acuity test used for measuring visual acuity development in toddlers

Abstract

Vision Research

Vision Research

Vision Research

Survey of Ophthalmology

The Cardiff Test: A new visual acuity test for toddlers and children with intellectual impairment. A preliminary report

Optometry and Visual Science

Contrast sensitivity function of preschool children

British Journal of Ophthalmology