Preschool visual acuity screening tests

Trans Am Ophthalmol Soc. 1978;76:383-480.


The purpose of the study was to evaluate the relative merits of two screening tests used for visual acuity assessment of preschool children. The tests that were compared were the Good-Lite Company versions of the E-Test and of the STYCAR (Screening Test for Young Children and Retardates). The former is the most popular method for evaluating central acuity in young children in this nation; the STYCAR is a relatively new letter-matching-test developed in England, where it is widely employed. The E-Test poses left-right orientation problems which are eliminated by the symmetrical letters H, T, O and V utilized in the Letter-Matching-Test. Both visual acuity tests were administered on two separate occasions by personnel from the Prevention of Blindness Society of Metropolitan Washington to 633 preschool children in Washington, D.C. By random selection, 150 of the children received the E-Test at both sessions, 162 children received the Letter-Matching-Test at both sessions, 160 chilt athe the second session, and 161 children received the Letter-Matching-Test at the first session and the E-Test at the second session. The author medically examined the eyes of 408 of the 633 children without knowledge of which test had been initially administered. Statistical analysis of the data obtained from the study indicated that the Letter-Matching-Test was significantly better in terms of testability rates, group and individual instruction time, and performance time. The E-Test was more reliable in terms of test-retest acuity scores and was also more valid in terms of agreement between pass-fail results obtained at the first screening session and two levels of pass-fail refraction criteria.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Amblyopia / diagnosis
  • Child
  • Child, Preschool
  • District of Columbia
  • Evaluation Studies as Topic
  • Eye Diseases / diagnosis*
  • Humans
  • Mass Screening
  • Psychometrics
  • Refractive Errors / diagnosis
  • Strabismus / diagnosis
  • United States
  • Vision Tests* / methods
  • Visual Acuity*