Interobserver Variability for Measurement of Grating Acuity in Preverbal and Nonverbal Children Using Lea Grating Paddles.

PURPOSE: To study interobserver variability for measurement of grating acuity in preverbal and nonverbal children with developmental delay using Lea Grating Paddles (Lea Hyvärinen).

METHODS

In this prospective study, preverbal patients younger than 3 years and older nonverbal patients (with developmental delay) were included. Those with poor neck holding were excluded. Binocular and monocular visual acuity assessment was done simultaneously using Lea Grating Paddles by two examiners who were blinded from each other's results.

RESULTS

Thirty-one children were tested (19 [61.29%] males and 12 [38.71%] females). The mean age was 28.5 months (range: 4 to 44 months). A total of 92% of the observations showed interobserver agreement of 0.5 octave or better in binocular testing. Results for monocular testing showed interobserver agreement (0.5 octaves or better) in 95.65% and 95.23% of right and left eyes, respectively. Combined results showed agreement better than 0.5 octaves in 94.20%. The mean binocular visual acuity was 2.07 and 2.14 cycles per degree (cpd) for the first and second observer, respectively (P = .59). Similarly, the mean monocular visual acuity for the right and left eyes was 0.98 and 0.97 cpd for observer 1 and 0.89 and 0.79 cpd for observer 2, respectively (P = .91 and .14, for the right and left eyes, respectively).

CONCLUSIONS

Interobserver variability for grating acuity measurement using Lea Grating Paddles is minimal, signifying it to be a reliable and reproducible alternative to conventional preferential looking testing procedures. [J Pediatr Ophthalmol Strabismus. 2020;57(5):305-308.].