Test-Retest Reliability of the Lea Symbols Chart in Preschool Children Aged 42-78 Months
Lei Song1, 2, Xuelan Chen1, Lijuan Chen3, Jianmin Hu1
1 Department of Ophthalmology, the Second Affiliated Hospital of Fujian Medical University, Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou 362000, China 2 Department of Ophthalmology, Qilu Children's Hospital of Shandong University, Jinan 250000, China 3 Department of Medical Technology, Zhang Zhou Health Vocational College, Zhangzhou 363000, China
Objective: To evaluate the repeatability of the Lea Symbols chart in vision examinations of preschool children. Methods: In this cross-sectional study, we included 250 children aged 42 through 78 months (61.9±10.3) from April to May 2017. All children completed comprehensive ophthalmological examinations and monocular assessment of visual acuity was performed in both eyes with the Lea Symbols chart. All visual acuity scores are presented in LogMAR units. Bland-Altman analysis, weighted Kappa test and correlation analysis were used to measure the reliability of repeated measurements between the two measurements. Results: The visual acuity (LogMAR) difference between test and retest thresholds was between ±0.10 in 94.3% of eyes. Correlation between test and retest thresholds was 0.753 (P<0.001). The mean difference in visual acuity (LogMAR) between test and retest was 0.014 in 139 preschool children without refractive errors. A significant relationship was found between age and visual acuity in 139 preschool children without refractive errors (rfirst=-0.335, P<0.001; rsecond=-0.424, P<0.001). Repeatability was not associated with gender (P=0.197). Conclusions: The Lea Symbols chart provides a repeatable measure of visual acuity in children 42 months and older. It is recommended for the clinical examination of children
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