title: Visual acuity testability in African-American and Hispanic children: the multi-ethnic pediatric eye disease study.
abstract: OBJECTIVE
  To compare the age- and gender-specific testability rates for the Amblyopia Treatment Study (ATS) HOTV visual acuity testing protocol using the electronic visual acuity (EVA) tester in African-American and Hispanic preschool children.
  
  
  METHODS
  Population-based, cross-sectional study.
  
  
  METHODS
  Measurement of presenting monocular distance visual acuity using the ATS HOTV protocol was attempted in all African-American and Hispanic children aged 30 to 72 months from the population-based Multi-Ethnic Pediatric Eye Disease Study (MEPEDS). Children able to be tested monocularly in both eyes were considered able. Age-, gender-, and ethnicity-specific testability rates were calculated. Comparisons of testability among different groups were performed using Chi-square analyses and the Cochran trend test.
  
  
  RESULTS
  Testing was attempted on 3,126 children (1,471 African-American, 1,655 Hispanic; 50% female). Overall, 84% (83% African-American, 85% Hispanic; 86% female, 82% male) were testable. Older children were more likely to complete testing successfully than younger children (P < .0001). Age-specific testability in children 30 to 36 months of age, 37 to 48 months of age, 49 to 60 months of age, and 61 to 72 months of age was 39%, 84%, 98%, and 100%, respectively. After stratifying by age, there were no ethnicity-related differences in children testable (P = .12). Girls (86%) were slightly more likely to be testable than boys (82%; P > .003).
  
  
  CONCLUSIONS
  Monocular threshold visual acuity testing using the ATS HOTV protocol on the EVA tester (Jaeb Center for Health Research, Tampa, Florida, USA) can be completed by most African-American and Hispanic preschool children, particularly those older than 36 months of age. This protocol therefore may be used in minority preschool children as an integral part of the diagnosis and management of amblyopia and other forms of visual impairment.
authors.affiliation: Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Cotter
authors.forename: Kristina
authors.initials: K
authors.lastname: Tarczy-Hornoch
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
authors.forename: Anne
authors.initials: A
authors.lastname: Dilauro
authors.forename: Mark
authors.initials: M
authors.lastname: Borchert
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
mesh_terms: D001741:Black or African American; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D014786:Vision Disorders / Q000175:diagnosis; D014787:Vision Tests / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology*