City Research Online

Abstract

There is a lack of validated clinical tools to measure visual functions in children with cerebral visual impairment (CVI). This study addresses this gap. Children aged 6 months-7 years with and without CVI (CVI, n = 111, mean age: 3.0 ± 1.9 years; 70.2 % male and without CVI, n = 50, mean age: 3.4 ± 1.9 years; 38 % male) were recruited. Grating acuity (GA) was evaluated using Teller Acuity Cards-II (TAC-II) and the Peekaboo Vision app (PV app), and contrast sensitivity (CS) using Hiding Heidi low contrast face cards (HH cards) and Ohio Contrast Cards (OCC). Retests were conducted within one month. The mean difference between the PV app and TAC-II was significant (CVI: −0.25 ± 0.40 logMAR, 95 % LoA: −1.03 to 0.53 logMAR; controls: −0.14 ± 0.30 logMAR, 95 % LoA: −0.72 to 0.44 logMAR). The median difference between the HH cards and OCC was also significant (CVI: 0.00 logCS, IQR: 0.25 logCS, 95 % LoA: −0.43 to 0.67 logCS; controls: 0.25 logCS, IQR: 0.00 logCS, 95 % LoA: −0.01 to 0.56 logCS). Intra-examiner repeatability analysis in children with CVI (n = 21) and controls (n = 16) revealed that TAC-II (CR, CVI = 0.47, controls = 0.27) had better repeatability than the PV app (CR, CVI = 0.99, controls = 0.41), while OCC (CR, CVI = 0.45, controls = 0.19) had better repeatability than HH cards (CR, CVI = 0.90, controls = 0.60). TAC-II and OCC demonstrated better repeatability and comparable testability, testing time, and engagement scores for GA and CS tests respectively in children with CVI. Findings indicate that clinical tools should not be used interchangeably, and clinicians must carefully interpret results based on each test’s repeatability indices.

Publication Type:	Article
Additional Information:	© 2025. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords:	Neurological visual impairment, Cortical visual impairment, Visual acuity, Validation, Agreement, Pediatric vision assessment
Subjects:	R Medicine > RE Ophthalmology R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Optometry & Visual Science
SWORD Depositor:	Symplectic Administrator

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