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August 1995

Grating Acuity Tests Should Not Be Used for Social Service Purposes in Preliterate Children-Reply

Author Affiliations

Madison, Wis

Arch Ophthalmol. 1995;113(8):971-972. doi:10.1001/archopht.1995.01100080020009

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In reply  My Editorial1 was written to emphasize three points. First, grating acuity with Teller Acuity Cards (TACs) is not equivalent to recognition acuity (Snellen acuity). Second, social service criteria for defining vision loss are based on Snellen acuity. Third, consequently, results from the TAC test should not be used to determine whether a preliterate child is legally blind.I am aware of many instances in which well-meaning clinicians have used TAC results in such a manner. I read nothing in the letter by Dr Fielder and coauthors that contradicts any of these points. Are they suggesting that the Snellen equivalent of TAC results should be used to determine whether a child sees 20/200 or poorer? I doubt it. Numerous studies have shown that grating acuity and recognition acuity are not equivalent.2 Are they suggesting that the results obtained with TACs be adjusted by some algorithm and that

Kushner BJ.  Grating acuity tests should not be used for social service purposes in preliterate children . Arch Ophthalmol . 1994;112:1030-1031.Article
Kushner BJ, Lucchese NJ, Morton GV.  Grating acuity with Teller Cards compared to Snellen acuity in literate patients . Arch Ophthalmol . 1995;113:485-493.Article
Dobson V, Teller DY.  Visual acuity in human infants: a review and comparison of behavioral and electrophysiologic studies . Vision Res . 1978;18:1469-1483.Article
Mayer DL, Dobson V.  Visual development in infants and young children as assessed by operant preferential looking . Vision Res . 1982;22:1141-1151.Article
Norcia AM, Tyler CW.  Spatial sweep VEP: visual acuity during the first year of life . Vision Res . 1985;25:1399-1408.Article