We have developed a new test for acuity measurements specifically designed for the hard to test group of toddlers and children with intellectual impairment. The test uses vanishing optotypes and the preferential looking technique. Comparison studies with established acuity tests, Snellen, Cambridge and Teller cards show that the test provides a realistic acuity measure. It is highly successful for toddlers and children with intellectual impairment and quicker to administer for the toddler age group.