Comparison of current paediatric contrast sensitivity assessments using simulated reduced contrast thresholds

ABSTRACT

Purpose

There are limited tests of contrast sensitivity (CS) for use in children. The Hiding Heidi (HH) is suitable for all cognitive abilities, but has a ceiling effect. The Double Happy (DH) test has comparable thresholds to the Pelli Robson (PR), however the ability to detect changes in contrast has not been established. This study aims to compare contrast thresholds and agreement between HH and the DH, comparing to the PR chart in normal conditions and under reduced visual and lighting conditions.

Methods

Tests were repeated under different conditions to reduce the contrast. Room illumination was 20,900{plus minus}2% lux in bright conditions and 2,000{plus minus}2% lux in dim conditions, both conditions were repeated with the addition of simulation spectacles to reduce the clarity of vision. Participants’ CS was measured uniocularly using the PR, HH and DH tests.

Results

50 participants, age 18–62 years (mean{plus minus}standard deviation: 24.5{plus minus}7.98), were assessed. On HH 94% (n = 47) reached the maximum score, with the DH it was 18% (n = 9). The difference in reduction between conditions was smaller with HH in comparison to PR and DH, but significantly different from baseline conditions. Under dim conditions the reduction in PR and DH was −0.21 logCS units, but only −0.04 logCS for HH.

Conclusion

The DH test has better agreement with PR than HH and is better at detecting CS changes, highlighting the advantages of use in clinical practice.

KEYWORDS:

• Contrast sensitivity
• pediatric
• visual function

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.