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Clinical Utility of 'Peekaboo Vision' Application for Measuring Grating Acuity in Children with Down Syndrome

Sumalini, R., Satgunam, P., Subramanian, A. ORCID: 0000-0001-8104-5312 & Conway, M. L. ORCID: 0000-0001-5016-0529 (2022). Clinical Utility of 'Peekaboo Vision' Application for Measuring Grating Acuity in Children with Down Syndrome. British and Irish Orthoptic Journal, 18(1), pp. 18-26. doi: 10.22599/bioj.264


Peekaboo Vision is an iPad grating acuity app built with typically developing children in mind. Given the ease of using this app in the pediatric age group, this study determined its clinical utility in children with Down syndrome. Two groups of participants (children with Down syndrome and age-matched controls) were included. Presenting binocular grating acuity was measured using Peekaboo Vision and Teller acuity cards II in random order. Parents' feedback about their child's engagement and time taken to complete each test was documented. Thirty-seven children with Down syndrome (males = 23; mean age = 8.1 ± 4.2 years) and 28 controls (males = 15; mean age = 8.71 ± 3.84 years) participated. Time taken to complete the tests was comparable (p = 0.83) in children with Down syndrome. Controls were significantly faster with Peekaboo Vision (p = 0.01). Mean logMAR acuities obtained with Peekaboo Vision (0.16 ± 0.34) and Teller acuity cards II (0.63 ± 0.34) were significantly different (p < 0.001) in children with Down syndrome (mean difference in acuities: -0.44 ± 0.38 logMAR (95% LoA: -1.18 to 0.3). For controls, the mean logMAR acuity with Peekaboo Vision (-0.13 ± 0.12) and Teller acuity cards II (0.12 ± 0.09) was also found to be significantly different (p < 0.001) (mean difference in acuities: -0.24 ± 0.14 logMAR (95% LoA: -0.51 to 0.03) Peekaboo Vision test can be used on children with Down syndrome. Peekaboo Vision and Teller acuity cards II can be used independently but not interchangeably. The differences in the acuity values between the two tests could be a result of the differences in the thresholding paradigms, different testing mediums and the range of acuities covered.

Publication Type: Article
Additional Information: © 2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See
Publisher Keywords: Down syndrome; Grating acuity; Peekaboo Vision; Teller acuity cards II
Subjects: R Medicine > RJ Pediatrics
Departments: School of Health & Psychological Sciences > Optometry & Visual Sciences
[thumbnail of 264-2260-1-PB.pdf]
Text - Published Version
Available under License Creative Commons: Attribution International Public License 4.0.

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