LogMAR chart | |
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Purpose | assess visual acuity |
A logMAR chart (Logarithm of the Minimum Angle of Resolution) is a chart consisting of rows of letters that is used by ophthalmologists, orthoptists, optometrists, and vision scientists to estimate visual acuity. The chart was developed at the National Vision Research Institute of Australia in 1976, and is designed to enable a more accurate estimate of acuity than do other charts (e.g., the Snellen chart). [1] For this reason, the LogMAR chart is recommended, particularly in a research setting. [2]
When using a LogMAR chart, visual acuity is scored with reference to the logarithm of the minimum angle of resolution, as the chart's name suggests. An observer who can resolve details as small as 1 minute of visual angle scores LogMAR 0, since the base-10 logarithm of 1 is 0; an observer who can resolve details as small as 2 minutes of visual angle (i.e., reduced acuity) scores LogMAR 0.3, since the base-10 logarithm of 2 is near-approximately 0.3; and so on.
Specific types of logMAR chart include the original Bailey-Lovie chart, [3] as well as the ETDRS charts, developed for the Early Treatment Diabetic Retinopathy Study. [4]
The chart was designed by Ian Bailey [5] and Jan E. Lovie-Kitchin at the National Vision Research Institute of Australia. [1] [3] They described their motivation for designing the LogMAR chart as follows: "We have designed a series of near vision charts in which the typeface, size progression, size range, number of words per row and spacings were chosen in an endeavour to achieve a standardization of the test task."
The Snellen chart, which dates back to 1862, is also commonly used to estimate visual acuity. A Snellen score of 6/6 (20/20), indicating that an observer can resolve details as small as 1 minute of visual angle, corresponds to a LogMAR of 0 (since the base-10 logarithm of 1 is 0); a Snellen score of 6/12 (20/40), indicating an observer can resolve details as small as 2 minutes of visual angle, corresponds to a LogMAR of 0.3 (since the base-10 logarithm of 2 is near-approximately 0.3), and so on.
Foot | Metre | LogMAR |
---|---|---|
20/200 | 6/60 | 1.00 |
20/160 | 6/48 | 0.90 |
20/125 | 6/38 | 0.80 |
20/100 | 6/30 | 0.70 |
20/80 | 6/24 | 0.60 |
20/63 | 6/18 | 0.50 |
20/50 | 6/15 | 0.40 |
20/40 | 6/12 | 0.30 |
20/32 | 6/9.5 | 0.20 |
20/25 | 6/7.5 | 0.10 |
20/20 | 6/6 | 0.00 |
20/16 | 6/4.8 | −0.10 |
20/12.5 | 6/3.8 | −0.20 |
20/10 | 6/3 | −0.30 |
Each letter has a score value of 0.02 log units. Since there are 5 letters per line, the total score for a line on the LogMAR chart represents a change of 0.1 log units. [6] The formula used in calculating the score is:
Given that each line has 5 optotypes, the equivalent formula is:
The LogMAR chart is designed to enable more accurate estimates of acuity as compared to other acuity charts (e.g., the Snellen chart). [1] Each line of the LogMAR chart comprises the same number of test letters (effectively standardizing the test across letter size); the letter size change from one line to the next is a constant ratio, as is the spacing between lines (making the chart easy to use at nonstandard viewing distances). In ETDRS charts, the Sloan letters are used (Sloan letters are perfectly square approximately equally legible one from another), while the Bailey–Lovie chart used rectangular (5:4) letters based on the Transport typeface, as set out in British Standard 4274:1968. [1]
Zero LogMAR indicates standard vision, positive values indicates poor vision, and negative values indicates good vision. This is less intuitive than other VA notations. However, LogMAR is actually a notation of vision loss.
The World Health Organization established criteria for low vision using the LogMAR scale. Low vision is defined as a best-corrected visual acuity worse than 0.5 LogMAR but equal or better than 1.3 LogMAR in the better eye. [7] Blindness is defined as a best-corrected visual acuity worse than 1.3 LogMAR. [7]
Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an animal's ability to recognize small details with precision. Visual acuity depends on optical and neural factors. Optical factors of the eye influence the sharpness of an image on its retina. Neural factors include the health and functioning of the retina, of the neural pathways to the brain, and of the interpretative faculty of the brain.
A Snellen chart is an eye chart that can be used to measure visual acuity. Snellen charts are named after the Dutch ophthalmologist Herman Snellen who developed the chart in 1862 as a measurement tool for the acuity formula developed by his professor Franciscus Cornelius Donders. Many ophthalmologists and vision scientists now use an improved chart known as the LogMAR chart.
An eye chart is a chart used to measure visual acuity comprising lines of optotypes in ranges of sizes. Optotypes are the letters or symbols shown on an eye chart. Eye charts are often used by health care professionals, such as optometrists, physicians and nurses, to screen persons for vision impairment. Ophthalmologists, physicians who specialize in the eye, also use eye charts to monitor the visual acuity of their patients in response to various therapies such as medications or surgery.
An eye examination, commonly known as an eye test, is a series of tests performed to assess vision and ability to focus on and discern objects. It also includes other tests and examinations pertaining to the eyes. Eye examinations are primarily performed by an optometrist, ophthalmologist, or an orthoptist. Health care professionals often recommend that all people should have periodic and thorough eye examinations as part of routine primary care, especially since many eye diseases are asymptomatic.
Herman Snellen was a Dutch ophthalmologist who introduced the Snellen chart to study visual acuity (1862). He took over directorship of the Netherlands Hospital for Eye Patients, after Franciscus Donders. He was elected an International Member of the American Philosophical Society in 1894.
The Landolt C, also known as a Landolt ring, Landolt broken ring, or Japanese vision test, is an optotype: a standardized symbol used for testing vision. It was developed by the Swiss-born ophthalmologist Edmund Landolt.
Visual angle is the angle a viewed object subtends at the eye, usually stated in degrees of arc. It also is called the object's angular size.
The LEA Vision Test System is a series of pediatric vision tests designed specifically for children who do not know how to read the letters of the alphabet that are typically used in eye charts. There are numerous variants of the LEA test which can be used to assess the visual capabilities of near vision and distance vision, as well as several other aspects of occupational health, such as contrast sensitivity, visual field, color vision, visual adaptation, motion perception, and ocular function and accommodation (eye).
Contrast is the difference in luminance or color that makes an object visible against a background of different luminance or color. The human visual system is more sensitive to contrast than to absolute luminance; thus, we can perceive the world similarly despite significant changes in illumination throughout the day or across different locations.
Sloan letters, designed by Louise Sloan in 1959, are a set of optotypes used to test visual acuity generally used in Snellen charts and logMAR charts.
Stereoscopic acuity, also stereoacuity, is the smallest detectable depth difference that can be seen in binocular vision.
The Australian College of Optometry (ACO) is an Australian non-profit working to improve the eye health and well-being of various Australian communities. Established in 1940, the ACO's goal is to deliver public health optometry, vision research and professional education.
Jan E. Lovie-Kitchin is an Australian optometrist, former professor at Queensland University of Technology and founder of the university's Vision Rehabilitation Centre. She was the co-developer of the Bailey-Lovie visual acuity chart.
Vernier acuity is a type of visual acuity – more precisely of hyperacuity – that measures the ability to discern a disalignment among two line segments or gratings. A subject's vernier acuity is the smallest visible offset between the stimuli that can be detected. Because the disalignments are often much smaller than the diameter and spacing of retinal receptors, vernier acuity requires neural processing and "pooling" to detect it. Because vernier acuity exceeds acuity by far, the phenomenon has been termed hyperacuity. Vernier acuity develops rapidly during infancy and continues to slowly develop throughout childhood. At approximately three to twelve months old, it surpasses grating acuity in foveal vision in humans. However, vernier acuity decreases more quickly than grating acuity in peripheral vision. Vernier acuity was first explained by Ewald Hering in 1899, based on earlier data by Alfred Volkmann in 1863 and results by Ernst Anton Wülfing in 1892.
The prism cover test (PCT) is an objective measurement and the gold standard in measuring strabismus, i.e. ocular misalignment, or a deviation of the eye. It is used by ophthalmologists and orthoptists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. Manifest is defined by the eye deviating constantly or intermittently, whereas latent is where the deviation is normally controlled but becomes present when the eyes are dissociated. A PCT reveals the total deviation and cannot distinguish between latent and manifest strabismus as you are using an alternate cover test.
Subjective Refraction is a technique to determine the combination of lenses that will provide the best corrected visual acuity (BCVA). It is a clinical examination used by orthoptists, optometrists and ophthalmologists to determine a patient's need for refractive correction, in the form of glasses or contact lenses. The aim is to improve current unaided vision or vision with current glasses. Glasses must also be comfortable visually. The sharpest final refraction is not always the final script the patient wears comfortably.
The Jaeger chart is an eye chart used in testing near visual acuity. It is a card on which paragraphs of text are printed, with the text sizes increasing from 0.37 mm to 2.5 mm. This card is to be held by a patient at a fixed distance from the eye dependent on the J size being read. The smallest print that the patient can read determines their visual acuity. The original 1867 chart had a text containing seven paragraphs and a corresponding seven-point scale.
Louise Littig Sloan was an American ophthalmologist and vision scientist. She is credited for being a pioneer of the sub-division of clinical vision research, contributing more than 100 scientific articles in which she either authored or co-authored. Her most notable work was in the area of visual acuity testing where she developed and improved equipment. Sloan received her Ph.D. from Bryn Mawr College in experimental psychology. She spent a short period of time in both Bryn Mawr's experimental psychology program as well as the Department of Ophthalmology at Harvard Medical School. The majority of her career, however, was spent at Johns Hopkins Wilmer Eye Institute where she directed the Wilmer Laboratory of Physiological Optics for 44 years. In 1971, Sloan was the second woman awarded the prestigious Edgar D. Tillyer Award by Optica (formerly Optical Society for her many achievements in the field of vision.
The MNREAD acuity chart or Minnesota low vision reading chart is a text based chart used to measure near visual acuity in people with normal or low vision. It can also be used to measure maximum reading speed, critical print size and the reading accessibility index of a person. Digital and printed types of charts are available.
Near visual acuity or near vision is a measure of how clearly a person can see nearby small objects or letters. Visual acuity in general usually refers clarity of distance vision, and is measured using eye charts like Snellen chart, LogMAR chart etc. Near vision is usually measured and recorded using a printed hand-held card containing different sized paragraphs, words, letters or symbols. Jaeger chart, N notation reading chart and Snellen's near vision test are the commonly used charts for measuring and recording near visual acuity. Near vision testing is usually done after correcting visual acuity at a distance.
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