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Amy Hutchinson, Keri Stalun, Michael Lynn, T Candy; The Handy Eye CheckTM: A Mobile Medical Application for Testing Vision in Children. Invest. Ophthalmol. Vis. Sci. 2013;54(15):583.
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The Handy Eye ChartTM uses hand gesture symbols as optotypes and is a valid test of visual acuity in children age 6 to 18 years.1 Modifications are needed to improve testability in younger children. The goal of this study was to develop an electronic version of the chart.
We developed an iPad application (the Handy Eye CheckTM) to test visual acuity by presenting isolated Handy Eye ChartTM optotypes with crowding bars according to the Amblyopia Treatment Study (ATS) protocol. Validity and reliability of the Handy Eye CheckTM were determined by comparing results with the previously validated chart and assessing test-retest results.
The poorest seeing eye of 61 children aged 6-18 years was tested. Visual acuity ranged from -0.1 to 1.0 logarithm of the minimal angle of resolution (logMAR). There was a strong linear correlation (r = .92) and a mean difference in acuity of -0.005 (less than one letter) (95% CI -0.03 to 0.02) logMAR, between the two tests. The 95% limits of agreement were ± 2 lines. Test-retest reliability was high, with 81% of retest scores within 0.1 logMAR (5 letters) and 100% within 0.2 logMAR (10 letters), an intraclass correlation coefficient of 0.93, and a standard error of measurement of 0.08.
: Validity and reliability testing of the Handy Eye CheckTM compares favorably to other pediatric acuity tests2 and to other studies of electronic testing protocols in children3The Handy Eye CheckTM is a valid and reliable test of visual acuity in children age 6-18 years. References: 1. Cromelin CH, Candy RT, Lynn MJ, Harrington CL, Hutchinson AK. The Handy Eye ChartTM: A New Visual Acuity Test for Use in Children. Ophthalmology 2012;119(10):2009-2013. 2. Vision in Preschoolers (VIP) Study Group. Visual acuity results in school-aged children and adults: Lea Symbols chart versus Bailey-Lovie chart. Optom Vis Sci 2003;80:650 - 4 3. Cotter S, Chu RH, Chandler DL et al. Reliability of the electronic early treatment diabetic retinopathy study testing protocol in children 7 to < 13 years old. AJO 2003;134(4);655-661.
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