title: Assessment of Grating Acuity in Infants and Toddlers Using an Electronic Acuity Card: The Dobson Card.
abstract: OBJECTIVE
  To determine if testing binocular visual acuity in infants and toddlers using the Acuity Card Procedure (ACP) with electronic grating stimuli yields clinically useful data.
  
  
  METHODS
  Participants were infants and toddlers ages 5 to 36.7 months referred by pediatricians due to failed automated vision screening. The ACP was used to test binocular grating acuity. Stimuli were presented on the Dobson Card. The Dobson Card consists of a handheld matte-black plexiglass frame with two flush-mounted tablet computers and is similar in size and form to commercially available printed grating acuity testing stimuli (Teller Acuity Cards II [TACII]; Stereo Optical, Inc., Chicago, IL). On each trial, one tablet displayed a square-wave grating and the other displayed a luminance-matched uniform gray patch. Stimuli were roughly equivalent to the stimuli available in the printed TACII stimuli. After acuity testing, each child received a cycloplegic eye examination. Based on cycloplegic retinoscopy, patients were categorized as having high or low refractive error per American Association for Pediatric Ophthalmology and Strabismus vision screening referral criteria. Mean acuities for high and low refractive error groups were compared using analysis of covariance, controlling for age.
  
  
  RESULTS
  Mean visual acuity was significantly poorer in children with high refractive error than in those with low refractive error (P = .015).
  
  
  CONCLUSIONS
  Electronic stimuli presented using the ACP can yield clinically useful measurements of grating acuity in infants and toddlers. Further research is needed to determine the optimal conditions and procedures for obtaining accurate and clinically useful automated measurements of visual acuity in infants and toddlers.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Mohan
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Miller
authors.forename: Erin M
authors.initials: EM
authors.lastname: Harvey
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Gerhart
authors.forename: Howard P
authors.initials: HP
authors.lastname: Apple
authors.forename: Deborah
authors.initials: D
authors.lastname: Apple
authors.forename: Jordana M
authors.initials: JM
authors.lastname: Smith
authors.forename: Amy L
authors.initials: AL
authors.lastname: Davis
authors.forename: Tina
authors.initials: T
authors.lastname: Leonard-Green
authors.forename: Irene
authors.initials: I
authors.lastname: Campus
authors.forename: Leslie K
authors.initials: LK
authors.lastname: Dennis
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage; D012030:Refractive Errors / Q000175:diagnosis / Q000503:physiopathology; D042262:Retinoscopy; D014787:Vision Tests / Q000295:instrumentation*; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D009184:Mydriatics