April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Critical Flicker Frequency (CFF) is Reduced in Children with Suspected Reading Disability
Author Affiliations & Notes
  • Barry Tannen
    Dept of Clinical Sciences,
    SUNY/State College of Optometry, New York, New York
  • Kenneth J. Ciuffreda
    Dept of Vision Sciences,
    SUNY/State College of Optometry, New York, New York
  • Noah M. Tannen
    Dept of Vision Sciences,
    SUNY/State College of Optometry, New York, New York
  • Footnotes
    Commercial Relationships  Barry Tannen, None; Kenneth J. Ciuffreda, None; Noah M. Tannen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 264. doi:
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      Barry Tannen, Kenneth J. Ciuffreda, Noah M. Tannen; Critical Flicker Frequency (CFF) is Reduced in Children with Suspected Reading Disability. Invest. Ophthalmol. Vis. Sci. 2011;52(14):264.

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

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Purpose: : To assess the critical flicker frequency threshold (CFF) clinically in children with suspected reading disability.

Methods: : The CFF threshold of 39 children between the ages of 7-16 years with suspected reading disability based on the chief complaint of "reading problems" was measured in the primary author’s private practice during the course of a comprehensive vision evaluation. 23 age-matched controls without any history or complaint of reading problems were also tested. CFF threshold was assessed binocularly with the habitual near prescription in place at 40 cm. The test light consisted of 4 contiguous white light-emitting diodes (LEDs) with which were mounted within a handheld rectangular enclosure and provided diffuse illumination via a circular translucent plexiglass cover. The size of the test field was 3.5 degrees with a luminance of 100cd/m2 performed in a dimly illuminated room. The flicker rate was controlled by a calibrated dial, which allowed the experimenter to gradually increase or decrease the flicker frequency over a range of 30 to 60 Hz. Patients were instructed to fixate the center of the test field, while the rate of flicker was either increased (‘‘stops flickering’’) or decreased (‘‘starts to flicker’’) at a rate of approximately 1 Hz per second. 3 ascending and 3 descending measurements were taken alternately. A single mean CFF threshold was obtained by averaging the 6 measurements.

Results: : Mean CFF threshold was 45.48Hz +/-3.0Hz in the normal readers and 39.59+/-1.4Hz in the patients with reading problems, which was significantly different (t-test, p<0.01). Only 3 of the 39 children (7.5%) with reading problems had a CFF threshold within 1 standard deviation of the mean CFF threshold of normal readers.

Conclusions: : Mean CFF threshold discriminated well between children with a chief complaint of reading problems and those with no history or report of reading problems. This agrees with earlier studies demonstrating reduced temporal processing reflecting visual magnocellular impairment in individuals with reading disability. We suggest that the CFF threshold test, which is both simple and rapid, be considered for inclusion in the clinical vision testing for children presenting with reading problems.

Keywords: reading • neuro-ophthalmology: diagnosis • temporal vision 

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