5 Key Takeaways
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1
In a cross-sectional study of 995 children aged 3 to 15 years in Shanghai, mean uncorrected visual acuity was better with HOTV than with tumbling E testing.
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2
Among children aged 3 to 4 years, HOTV and tumbling E results differed by 1 logMAR line, with differences exceeding 3 letters in children younger than 8 years.
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3
Among 183 preschool children, reduced visual acuity was identified in 18.6% with HOTV and 31.2% with tumbling E; HOTV had higher true-positive rates and specificity.
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4
Testability was similar for HOTV and tumbling E, at 95.1% and 96.5%, respectively, although HOTV required modestly longer instruction and testing time.
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5
Both tests missed some hyperopia and borderline refractive errors, and same-day administration may have introduced fatigue despite a 30-minute rest period.
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