Comparison of Lea Gratings (LG) with Cardiff Acuity Cards for Vision ...

524 AIOC 2010 PROCEEDINGS
AUTHORS’S PROFILE:
Dr. KRUTI MODY: M.B.B.S. (‘99), Maharashtra University of Health Sciences (MUHS); DNB
(2009), Aditya Jyot Eye Hospital, Mumbai. Presently, Research Fellow in Oculoplasty at LVPEI.
E-mail: krutimody@gmail.com
Comparison of Lea Gratings (LG) with Cardiff Acuity Cards
for Vision Testing of Preverbal Children
Dr. Kruti Mody, Dr. Mihir Trilok, Kothari, Dr. Debapriya Chatterjee.
(Presenting Author: Dr. Kruti Mody)
Measuring visual acuity (VA) in children,
especially preverbal children, has always
been a difficult task. Forced preferential looking
(FPL) tests like grating acuity (GA) test [Teller
Acuity Card (TAC)] and vanishing optotype test
[Cardiff Acuity Card (CAC)] are well established
for this purpose. A study comparing the two has
been done. 1 Lea grating (LG) test is new grating
based acuity test. It is in form of 2 paddles,
making the test more convenient. Also, it is
relatively cost-effective, which is a major concern
when it comes to tests like TAC (1500$US). In this
study, we have compared CAC (500£) to LG
(200$).
In this study, we also report the normative data
of visual acuity testing using CAC and LG test
for children between 6 months to 3 years.
Materials and Methods
Children aged 6 months - 3 years coming to an
‘immunisation clinic’ and ‘well baby clinic’ at a
civil hospital were recruited to generate the
normative data. Amblyopic children were
recruited from the Pediatric Eye Care Centre.
Children with nystagmus, cataract, squint etc
and neurological deficits, delayed milestones,
systemic acute or chronic illnesses were not
included in the normative database. The patients
recruited for comparison of CAC and LG test
were having either anisometropic amblyopia/
strabismic amblyopia diagnosed after a complete
ophthalmic examination (including cycloplegic
refraction with atropine) by a Pediatric
Ophthalmologist. Patients with other ocular or
systemic comorbidity were excluded.
Uncooperative children with unreliable results
(as judged by the examiner) were also excluded
from the study.
The monocular and binocular visual acuity in all
was recorded using CAC and LG by the same
examiner. CAC were used from a distance of
50cm and LG were evaluated from 57cm as
recommended by the manufacturers. If the
child’s visual acuity was better than that detected
at the required distance, testing distance was not
increased. This was done to avoid loss of
attention associated with testing of vision at far
distance in young children. The LG test was
performed first with both eye open followed by
right eye open and left eye of the child closed by
a micropore tape / a hand of the mother while
the child sat in the mother’s lap followed by the
evlaution of vision in the left eye. A break of 5 –
15 minutes was given between the two tests to
maintain the child’s alertness during the test. The
same procedure was repeated with the CAC test.
The results of the two tests were compared.
Result
Demographics
Amblyopic Children Healthy Children
Total No. 30 (60 eyes) 200 (400 eyes)
(6/36 were excluded
do due inability to
test/ fixate)
Mean Age 19.9 ± 11
(months) 28.23+5.88 (36–14)
M:F 12:18 110:90
Outcomes
CAC LG
Binocular VA 0.95±0.3 1.0±0.6 Pearson’s
(in LogMAR) (0.7–1.2) (0.5–2.1) correlation
coefficient=0.98

PEDIATRIC OPHTHALMOLOGY SESSION
525
Monocular VA 1.32±0.08 1.15± 0.15 Pearson’s
(in LogMAR) (0.2–0.6) (0.8 –1.48) correlation
coefficient=0.63
Time taken to 31.59+5.05 23.11±4.61 p = 0.0008
perform test (25–65) (20–50)
(secs.)
Discussion
Our study shows that both the tests were useful
in assessment of VA in preverbal children above
6 months of age. We agree to the previous
authors that CAC is more suitable for children
above 12 months of age.2 LG is more suitable for