Daphne L. McCulloch

Purpose: To investigate the testability of the WatDAT for measuring recognition visual acuity (VA) in children aged between 18 to 48 months, report preliminary age‐related data and compare with two commercially available matching tests. Methods: A total of 57 children (18.5–45.8 months) attended for two sessions. Forty‐six children were placed in a typical group and 11 were classified as atypical if general or ocular health history or prematurity was reported. Binocular and monocular VA was attempted with WatDAT House/Circle (HC) and WatDAT Faces. Binocular VA was attempted with Kay Pictures and Patti Pics. The percentage able to complete each test (testability) and the corresponding VA are reported. Results: The percentage of typical children able to complete binocular testing with the WatDAT HC, WatDAT Faces, Patti Pics and Kay Pictures was 96%, 86%, 75% and 80%, respectively. More children were testable with the binocular WatDAT HC compared to the Patti Pics and with WatDAT HC compared to Kay Pictures ( p = 0.03). Monocularly, 56% and 54%, respectively, were testable with WatDAT HC and WatDAT Faces for both eyes. VA improved with age for all measures. Repeated measures ANOVA indicated that there was no significant difference between binocular VA with WatDAT HC and WatDAT Faces ( p = 0.07), but there was a significant difference between the other tests. Both WatDAT tests gave poorer VA than the Patti Pics or Kay Pictures, while the Patti Pics gave poorer VA than Kay Pictures. Of the atypical children, 82% completed both the WatDAT HC and WatDAT Faces binocularly. Conclusions: WatDAT HC had good testability, comparable or better than testability for other tests for younger age groups as reported in the literature. Additionally, the results indicate higher testability with the WatDAT HC compared to Patti Pics matching and Kay Pictures. VA improved with age from 18 to 47 months.

Purpose: In Canada, teaching in paediatric eye care has increased in the past decade both within the optometry curriculum and as continuing education to optometrists. Paediatric vision care guidelines have also been established by North American optometric associations. This study examined whether this exposure was associated with changes in paediatric eye care in Canada over a 14‐year period. Methods: Canadian optometrists were invited to participate in an anonymous 35‐item survey in 2007 and 2021. The surveys sought to investigate optometrist's recommendations for first eye examinations, the number of paediatric patients seen in a typical week and preparedness to provide eye examinations to children. Response frequencies were determined for each survey item. Results: Across Canada, 133/1000 (13.3%) and 261/~6419 (~4.1%) optometrists responded to the survey in 2007 and 2021, respectively. No significant difference was found in the number of years practicing, days per week in practice and total number of patients seen per week. The modal age optometrists recommended children be seen for their first eye examination changed from 3–4 years in 2007 (53%) to 6–12 months in 2021 (61%). In 2007, 87% of respondents provided eye examinations to children p = 0.02). Despite a reduction in the recommended age between the two survey years, the most frequent age children were seen for their first eye examination was 3‐4 years (30% in both surveys) and the most common age seen in a typical week remained unchanged (4–6 years—56% 2007; 66% 2021). Conclusion: Although optometrists' willingness to provide paediatric eye care increased over the past 14 years, the number of children seen in a typical week did not change. Barriers to determine why more children are not being seen at an earlier age need to be investigated.

Background/objectives: To examine prevalence of failed visual assessment at 8–10 years in children born to methadone-maintained opioid dependent (MMOD) mothers and relate this to known in utero substance exposure. Subjects/methods: Follow up of observational cohort study of methadone-exposed and comparison children matched for birthweight, gestation and postcode of residence at birth. Participants were 144 children (98 exposed, 46 comparison). Prenatal drug exposure was previously established via comprehensive maternal and neonatal toxicology. Children were invited to attend for visual assessment and casenotes were reviewed. Presence of acuity poorer than 0.2 logMAR, strabismus, nystagmus and/or impaired stereovision constituted a ‘fail’. Fail rates were compared between methadone-exposed and comparison children after adjusting for known confounding variables. Results: 33 children attended in person: data were also derived from casenote review for all children. After controlling for maternal reported tobacco use, methadone-exposed children were more likely to have a visual ‘fail’ outcome, adjusted odds ratio 2.6, 95% CI 1.1–6.2; adjusted relative risk 1.8 (95% CI 1.1–3.4). Visual ‘fail’ outcome rates did not differ between methadone-exposed children who had (n = 47) or had not (n = 51) received pharmacological treatment for neonatal abstinence/opioid withdrawal syndrome (NAS/NOWS); fail rate 62% vs 53% (95% CI of difference—11–27%). Conclusions: Children born to MMOD mothers are almost twice as likely as unexposed peers to have significant visual abnormalities at primary school age. Prenatal methadone exposure should be considered in the differential diagnosis of nystagmus. Findings support visual assessment prior to school entry for children with any history of prenatal opioid exposure. Trial registration: The study was prospectively registered on ClinicalTrials.gov (NCT03603301), https://clinicaltrials.gov/ct2/show/NCT03603301.

This document developed by the International Society for Clinical Electrophysiology of Vision (ISCEV) provides guidance for calibration and verification of stimulus and recording systems specific to clinical electrophysiology of vision. This guideline provides additional information for those using ISCEV Standards and Extended protocols and supersedes earlier Guidelines. The ISCEV guidelines for calibration and verification of stimuli and recording instruments (2023 update) were approved by the ISCEV Board of Directors 01, March 2023.

Visual acuity measurement is important for the detection and monitoring of eye disorders. Developing accurate and sensitive visual acuity tests suitable for young children is therefore desirable.Re...