March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
The Handy Eye ChartTM: A New Visual Acuity Test for Use in Non-Verbal, or Developmentally Challenged Patients
Author Affiliations & Notes
  • Caroline H. Cromelin
    Emory University School of Medicine, Atlanta, Georgia
  • Cindy Lou Harrington
    Dekalb County School System, Atlanta, Georgia
  • Michael J. Lynn
    Rollins School of Public Health of Emory University, Atlanta, Georgia
  • T. Rowan Candy
    Indiana University School of Optometry, Bloomington, Indiana
  • Amy K. Hutchinson
    Department of Ophthalmology,
    Emory University School of Medicine, Atlanta, Georgia
  • Footnotes
    Commercial Relationships  Caroline H. Cromelin, Handy Eye Chart (TM) (P); Cindy Lou Harrington, Handy Eye Chart (TM) (P); Michael J. Lynn, None; T. Rowan Candy, None; Amy K. Hutchinson, Handy Eye Chart (TM) (P)
  • Footnotes
    Support  Unrestricted gift from The Georgia Knights Templar Foundation, unrestricted grant from Research to Prevent Blindness, Inc., New York, NY, National Eye Institute Departmental Core grant EY06360
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 4792. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Caroline H. Cromelin, Cindy Lou Harrington, Michael J. Lynn, T. Rowan Candy, Amy K. Hutchinson; The Handy Eye ChartTM: A New Visual Acuity Test for Use in Non-Verbal, or Developmentally Challenged Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4792.

      Download citation file:

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

  • Supplements

Assessing vision in non-verbal or developmentally challenged children is difficult. The Handy Eye ChartTM contains images of hands in four positions assembled into a linear eye chart (see Figure 1.) designed in accordance with accepted standards for visual acuity chart construction.1,2 Children imitate the gestures with their own hand. The purpose of this study is to compare visual acuity results obtained using the Handy Eye ChartTM with visual acuity results obtained with the Early Treatment Diabetic Retinopathy Study (ETDRS) chart in children.


Participants were 59 children between 6 and 17 years of age, recruited consecutively from the Pediatric Ophthalmology section of the Emory Eye Center. Monocular visual acuity was tested with the Handy Eye ChartTM and the ETDRS chart, alternating the order of administration between subjects. Testing was done on the child’s worst seeing eye.


Outcome measures were monocular logarithm of the minimum angle of resolution (logMAR) visual acuity scores for each chart. The charts were shown to have a strong linear correlation with a correlation coefficient of 0.94 and a mean difference in acuity between the two charts of -0.10 +/- 0.11 logMAR.


The difference shown is equivalent to approximately one line of acuity difference, with the Handy Eye ChartTM underestimating the vision as determined by the ETDRS chart. The present study supports the validity of the Handy Eye ChartTM as a measure of visual acuity in pediatric patients ages 6 to 18.  

Keywords: visual acuity 

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.