March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
An Exploratory Study To Compare The Reliability, Validity, And Acceptability Of Four Near Visual Acuity Charts
Author Affiliations & Notes
  • Tasanee Braithwaite
    Ophthalmology, Moorfields Eye Hospital, London, United Kingdom
  • Sheila Rae
    Vision and Hearing Sciences,
    Anglia Ruskin University, Cambridge, United Kingdom
  • Daryl Tabrett
    Vision and Eye Research Unit (VERU),
    Anglia Ruskin University, Cambridge, United Kingdom
  • Shahina Pardhan
    Vision and Eye Research Unit (VERU),
    Anglia Ruskin University, Cambridge, United Kingdom
  • Rupert R. Bourne
    Vision and Eye Research Unit (VERU),
    Anglia Ruskin University, Cambridge, United Kingdom
  • Footnotes
    Commercial Relationships  Tasanee Braithwaite, None; Sheila Rae, None; Daryl Tabrett, None; Shahina Pardhan, None; Rupert R. Bourne, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 3603. doi:https://doi.org/
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      Tasanee Braithwaite, Sheila Rae, Daryl Tabrett, Shahina Pardhan, Rupert R. Bourne; An Exploratory Study To Compare The Reliability, Validity, And Acceptability Of Four Near Visual Acuity Charts. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3603. doi: https://doi.org/.

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

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Abstract
 
Purpose:
 

There are an estimated 410 million people with uncorrected presbyopia globally, but the available data are limited by the lack of a standardized approach to near vision assessment. Reading tests estimate functional vision but are inappropriate for illiterate adults, who make up 16% of the global population. LogMAR near visual acuity(NVA) charts with literacy-independent optotypes are commercially available but have not previously been validated or compared.

 
Methods:
 

Repeated measures of binocular NVA were made for each distance-corrected subject, in the uncorrected(u) and best-corrected(c) near states. Luminance, illuminance, chart contrast and test distance were controlled in an optical lab. Corrected distance visual acuity(cDVA) was measured on a 3m ETRDS chart. The lens power needed to read N5 at 0.40m was recorded. Four NVA charts with identical design but differing optotypes were compared(Goodlite, USA): ETDRS with Sloan letters; four orientation tumbling E; four orientation Landolt C; and four Lea symbols. Time to determine uNVA and acceptability were assessed for each chart. The MNRead test was administered.

 
Results:
 

13 presbyopic subjects were included. The mean age was 57.6(10.9) years, 8 were male, and the mean lens power was +1.95(0.50) DS. The mean cDVA was -0.18(0.10) logMAR. Table 1 shows the mean NVA and test times. Repeated measures ANOVA with a Greenhouse-Geisser correction identified significant differences between the charts in uNVA(F=13.45,p<0.0005), cNVA(F=13.42,p<0.0005) and test time(F=16.81,p<0.0005). Post-hoc tests explored pairwise differences with a Bonferroni correction. The cNVA was significantly lower than the cDVA for all charts(p<0.01). The uNVA was significantly lower on the C than the other charts(p<0.0005). Test time was significantly faster on the ETDRS chart(p<0.03). Pearson correlation coefficients (Table 1) revealed strong associations between uNVA and reading acuity(p<0.0005), critical print size (p<0.0005), and add lens power (p<0.01) for all charts.

 
Conclusions:
 

The charts generated reliable, valid measures of NVA and were acceptable to a sample of literate, presbyopic subjects. Significant differences in the observed NVA between charts merit further investigation.  

 
Keywords: visual acuity • clinical (human) or epidemiologic studies: systems/equipment/techniques • presbyopia 
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