Comparison of two visual acuity tests in school enrolment examinations : Tumbling e test versus Freiburg visual acuity test
Bach, M.; Reuter, M.; Lagrèze, W.A.
Der Ophthalmologe Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 113(8): 684-689
ISSN/ISBN: 1433-0423 PMID: 27048550 DOI: 10.1007/s00347-016-0246-4
On the initiative of professionals performing vision screening for primary school enrolment, we compared the laptop-based Freiburg acuity and contrast test (FrACT) as a more easily portable alternative to the traditionally employed tumbling E vision test. We assessed vision with both methods in 326 children (647 eyes) aged 3.8-6.9 years. The FrACT was set to present the Landolt C optotype with the four cardinal orientations and automatic threshold bracketing over 18 presentations. The 95% limits of agreement between both methods were ±0.125 logMAR and 95% of all test differences were within slightly more than ±1 line. Over the examined age range acuity significantly but weakly increased (p < 0.01) from 0.7 to 0.9 and for Landolt Cs the acuity gain was slightly higher by 0.02 logMAR per year. The FrACT results were ≥3 lines lower than those of the tumbling E chart in only 6 eyes. The examiners unanimously preferred FrACT. The agreement between both tests of approximately ±1 lines is very high. The low outlier rate of <1% is deemed to be acceptable for a screening test.