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. 2002 May;86(5):513-6.
doi: 10.1136/bjo.86.5.513.

Examination of young children with Lea symbols

R Becker  1 , S Hübsch, M H Gräf, H Kaufmann
Affiliations

Examination of young children with Lea symbols

R Becker et al. Br J Ophthalmol. 2002 May.

Abstract

Aims: In order to establish normal values and interocular differences of visual acuity, Lea symbols were applied to neurologically and ophthalmologically normal children.

Methods: 385 children (21-93 months old) were examined, within a routine check up in an urban paediatric practice where Lea symbol acuity (LS) was measured. Of these children, 90 were re-examined in hospital comparing Lea symbol acuity (LS) and Landolt C acuity (LC). Strabismus, ametropia, and any organic eye disease were excluded.

Results: In the paediatric practice, LS could be measured on both eyes in 54% of the children. In the age group above 36 and 48 months the success rate was 76% and 95%, respectively. Acuity in the paediatric practice ranged from 0.1 to 2.0 (median 1.25) in the whole group. Interocular acuity difference was one line or less in 80%. In the hospital, LS and LC could be measured on both eyes of 77% and 48% of the 90 children, respectively. Cooperation increased with age. LS in the hospital ranged from 0.32 to 2.0 (median 1.0) and LC from 0.16 to 1.25 (median 0.8). Interocular difference of LS acuity was one line or less in 90%.

Conclusion: Lea symbols were found to be useful for visual acuity assessment in early childhood. Significant variability of visual acuity in this age group is caused by cooperation. When monocular measurements are possible on both eyes, however, the intraindividual interocular difference of visual acuity usually does not exceed one line.

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Figures

Figure 1
Figure 1
Lea symbols compared with the Landolt C corresponding to the same visual acuity. The diameter of the Lea symbols is about 20% larger than the diameter of the corresponding Landolt C. While the Landolt C contains only one critical detail (the gap), the house, apple, and square differ from the circle in more details.
Figure 2
Figure 2
Box plots of Lea single symbol acuity (“better” eye of each child) of 208 children examined monocularly on both eyes in the paediatric practice.
Figure 3
Figure 3
Box plots of Lea single symbol acuity (“better” eye of each child) of 69 children examined monocularly on both eyes in the hospital.
Figure 4
Figure 4
Lea single symbol acuity (LS) measured in the paediatric practice plotted against the LS measured in the hospital. The mean difference LSpractice – LShospital was 1.3 lines. A difference of more than one line occurred in nine children (21%).
See this image and copyright information in PMC

Comment in

  • Use of Lea symbols in young children.
    Repka MX. Repka MX. Br J Ophthalmol. 2002 May;86(5):489-90. doi: 10.1136/bjo.86.5.489. Br J Ophthalmol. 2002. PMID: 11973238 Free PMC article. No abstract available.

References

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