Assessing Distance Visual Acuity in Preschoolers

With minor variations, Procedure 6-1 can be used to test distance visual acuity in preschoolers. The Snellen Big E chart is used for this purpose.

A child needs a complete and thorough explanation of what is expected of him or her before beginning the test. Tell the child you will be playing a pointing game. Do not force the child to play the game because the results would then tend to be inaccurate. Draw the capital letter E on an index card, and teach the child to point in the direction of the open part of the E by turning the card in different di­rections (up, down, to the right, and to the left). Using such phrases as the "fingers" or the "legs of the table" to describe the open part of the E helps the child understand what is expected (Figure 6-5). Allow the child to practice the pointing game with the index card until you are sure this level of skill has been mastered. Be sure to praise the child when the correct response is given.

The child might need help holding the eye occluder in place. The aid of another person such as the parent would then be required.