Purpose:
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.
Methods:
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.
Results:
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.
Conclusions:
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.