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Russell J. Adams, Doreen E. MacNeil, Christina Dove, Mary L. Courage; Optics and psychophysics in a clinical setting: Success of a screening battery for assessing visual functioning in human infants. Journal of Vision 2008;8(6):414. doi: 10.1167/8.6.414.
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Purpose: The emergence of new time-efficient, portable, and user-friendly psychophysical technologies for young children now creates the possibility of mass screening programs for detecting early eye and visual dysfunction. Recent experimental work suggests that vision screening in 3–5 yr-old preschool children is feasible and that it can prevent or reduce long term visual pathology. Here, we expand on this work by attempting to extend vision screening to even younger children, namely infants who are still within the most critical phase of visual and CNS plasticity.
Methods: 6- and 12-month-old infants (n = 70) were assessed with a battery of the latest optical and psychophysical tests. Within a single session, we attempted to measure, for each eye, optical refractive error (Welch Allyn SureSight non-cycloplegic autorefractor), visual acuity (TAC), contrast sensitivity (CS sine-wave cards and PV low contrast faces test), and conducted a full ocular alignment/motility examination. For comparison, 2- and 3-year-olds (n = 120) were assessed with an equivalent battery of tests.
Results: The test battery was reasonably successful. With the exception of the CS card test, most infants and preschoolers completed all tests for each eye [83% (6 months), 70% (12 months), 62% (2 years) and 71% (3 years)], in a mean time ranging from 9.2 - 14.6 min.
Conclusions: Given the subject population, this was an ambitious test battery, especially as all infants and young children had to wear monocular occlusion for most tests. Nonetheless, most completed all tests for each eye within a single session. This speaks to the progress made by psychophysical and clinical researchers in developing effective pediatric vision tests. Moreover, in settings with continuous or repeated access to young children, (e.g., a daycare, public health or breast-feeding clinics), it should be feasible for even young infants to complete a full vision screening during this critical developmental period.
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