June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
Author Affiliations & Notes
  • Danielle Coury
    Ophthalmology, The Ohio State University, Columbus, OH
  • Julie Racine
    Ophthalmology, Nationwide Childrens Hospital, Columbus, OH
  • David Rogers
    Ophthalmology, The Ohio State University, Columbus, OH
    Ophthalmology, Nationwide Childrens Hospital, Columbus, OH
  • Footnotes
    Commercial Relationships Danielle Coury, None; Julie Racine, None; David Rogers, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 3865. doi:
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      Danielle Coury, Julie Racine, David Rogers; THE MULTIPLE RAREBIT TEST (DIGITSTEP): FEASIBITILY STUDY IN A PEDIATRIC POPULATION. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3865.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: PURPOSE: <br /> In adult patients, assessment of vision is often measured by visual acuity alone. Although suitable to detect optical defect, visual acuity may fail to detect anomalies of the retina and/or the optic nerve. Alternative tests such as the Humphrey visual field (HVF) and the contrast sensitivity test (CST) have been used to address the above. More recently, a new technique was developed, the multiple rarebit test, to quickly address neuronal damage in patients with optic nerve anomalies. The multiple rarebit test has been used in adults with success, but has not been used in pediatric populations. Therefore, the purpose of this study was to 1- assess the feasibility of this new method in a pediatric population and 2- to compare the results with other methods such as the VF and the CST.

Methods: METHODS: <br /> Ten subjects aged between 5 and 10 years of age with no known ophthalmic pathology were recruited from the Nationwide Children’s Hospital eye clinic to participate. Four tests were obtained for all participants: Snellen visual acuity (VA), Humphrey visual field (HVF), contrast sensitivity (CST) and multiple rarebit test (Digitstep). All tests were performed monocularly and both eyes were tested in the same session. Time to complete the test, ‘likeliness’ of the test and the efforts needed to perform the test were compiled.

Results: RESULTS: <br /> All subjects were able to perform all four tests. The VA, CST and the Digitstep were well performed by subjects. Each test took less than 5 minutes to complete and subjects enjoyed the tests. On the other hand HVF was very difficult to perform in younger patients (≤ 6y.o) and it was time-consuming.

Conclusions: CONCLUSION: <br /> The multiple rarebit test in a pediatric population is feasible. It is easier for a child to perform the multiple rarebit test than to perform the HVF. It is a quick test that children enjoyed. We noticed two downsides of the test, first being the speed at which the numbers are presented is fixed and can be sometimes too fast for the younger subjects (≤6 years old) and second the digital numbers 2 and 5 are similar in morphology and are often mistaken one another in children younger than 6 years of age. In the future, the multiple rarebit test could be use to asses the utility of the multiple rarebit test in children affected with retinal or optic nerve damage.


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