Preliminary Application of an Automated Acuity Detection System in Infant
Visual Acuity Evaluation
Jing Wen 1, Xiaoqing Li 1, Bikun Yang 2, Jinshi Cui 2, Li Wang 3, Yiwen Cao 1, Jinyu Cui 4, Yiping Wu 4, Wei Chen 5, Shanshan Xing 5
1Department of Pediatric Ophthalmology, Peking University First Hospital, Peking University Children
Vision Institute, Beijing 100034, China
2Key Laboratory of Machine Perception, Peking University, Beijing 100190, China
3School of Psychological and Cognitive Sciences, Peking University, Beijing 100080, China
4Xicheng District Maternal and Child Health Care Hospital, Beijing 100054, China
5Haidian District Maternal and Child Health Care Hospital, Beijing 100080, China
Abstract：Objective: To explore the application of the automated acuity card procedure (AACP) developed by the
Peking University First Hospital, the School of Electronics Engineering and Computer Science and the
School of Psychological and Cognitive Sciences of Peking University. Methods: Prospective clinical
study. From February 2018 to October 2021, using the AACP jointly developed by multiple colleges and
departments of Peking University, children aged 5 months to 6 years old were tested automatically, and
the Teller Acuity Card II (TAC-II) was used for manual detection at the same time. The results of the
two tests were compared. The Wilcoxon sign rank test, Spearman rank correlation, and Bland-Altman
plots were used to compare the differentiation, correlation and consistency between AACP and TAC-
II. Results: All 33 children (66 eyes) aged 3-6 years completed the binocular visual acuity test of AACP
and TAC-II. Among them, 30 children (54 eyes) completed the monocular visual acuity test of AACP and
TAC-II. The completion rate of the binocular visual acuity test was 100%, and the completion rate of the
monocular visual acuity test was 90.0%. Among 194 infants (388 eyes) aged 5-30 months, 141 infants
(282 eyes) completed the binocular visual acuity test of the two methods and obtained effective data, with
a completion rate of 72.7%. The AACP of 33 children aged 3-6 years was positively correlated with TAC-
II binocular visual acuity and monocular visual acuity (r=0.40, P=0.021; r=0.55, P<0.001). There was a
strong correlation between AACP and TAC-II binocular vision in 141 infants aged 5-30 months (r=0.88,
P<0.001), and the correlation coefficient was higher than that of children aged 3-6 years, the Bland-Altman
test showed 90.8 % points were all within the consistent range. There was a significant positive correlation
between AACP and TAC-II visual acuity between different months of age (r=0.82-0.94, all P<0.05),
and there was a statistically significant difference in AACP visual acuity between different months of age
(H=32.02, P<0.001), with a trend that increased with age. Conclusion: There was a positive correlation
between the visual acuity results obtained by the AACP and the TAC-II, especially with better results in
young infants. The AACP is expected to become a useful tool suitable for clinical grating acuity evaluation
and infant vision screening.
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