LogMAR chart

Last updated
LogMAR chart
ETDRS Chart R.svg
ETDRS Chart R, a type of logMAR chart
Purposeassess 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]

Contents

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]

History

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."

Relation to the Snellen chart

Snellen chart Snellen chart.svg
Snellen chart

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.

Recording visual acuity using the LogMAR chart

Visual acuity scales
FootMetreLogMAR
20/2006/601.00
20/1606/480.90
20/1256/380.80
20/1006/300.70
20/806/240.60
20/636/180.50
20/506/150.40
20/406/120.30
20/326/9.50.20
20/256/7.50.10
20/206/60.00
20/166/4.8−0.10
20/12.56/3.8−0.20
20/106/3−0.30

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:

Advantages of LogMAR over other charts

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.

Low vision and blindness definition with LogMAR

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]

Related Research Articles

<span class="mw-page-title-main">Visual acuity</span> Clarity of vision

Visual acuity (VA) commonly refers to the clarity of vision, but technically rates a person'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.

<span class="mw-page-title-main">Snellen chart</span> Eye chart

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. Many ophthalmologists and vision scientists now use an improved chart known as the LogMAR chart.

<span class="mw-page-title-main">Eye chart</span>

An eye chart, or optotype, is a chart used to subjectively measure visual acuity. Eye charts are often used by health care professionals, such as optometrists, physicians or 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.

<span class="mw-page-title-main">Eye examination</span> Series of tests assessing vision and pertaining to the eyes

An eye examination 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.

<span class="mw-page-title-main">Herman Snellen</span> Dutch ophthalmologist

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.

<span class="mw-page-title-main">Landolt C</span>

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.

<span class="mw-page-title-main">Lea test</span>

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).

<span class="mw-page-title-main">Contrast (vision)</span> Difference in luminance and/or color that makes objects visually distinguishable

Contrast is the contradiction in luminance or colour that makes an object distinguishable. In visual perception of the real world, contrast is determined by the difference in the colour and brightness of the object and other objects within the same field of view. The human visual system is more sensitive to contrast than absolute luminance; we can perceive the world similarly regardless of the huge changes in illumination over the day or from place to place. The maximum contrast of an image is the contrast ratio or dynamic range. Images with a contrast ratio close to their medium's maximum possible contrast ratio experience a conservation of contrast, wherein any increase in contrast in some parts of the image must necessarily result in a decrease in contrast elsewhere. Brightening an image will increase contrast in dark areas but decrease contrast in bright areas, while darkening the image will have the opposite effect. Bleach bypass destroys contrast in both the darkest and brightest parts of an image while enhancing luminance contrast in areas of intermediate brightness.

<span class="mw-page-title-main">Sloan letters</span>

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.

<span class="mw-page-title-main">Optimum HDTV viewing distance</span> Television placement for immersive experience

Optimum HDTV viewing distance is the distance that provides the viewer with the optimum immersive visual HDTV experience.

Stereoscopic acuity, also stereoacuity, is the smallest detectable depth difference that can be seen in binocular vision.

<span class="mw-page-title-main">Australian College of Optometry</span>

The Australian College of Optometry (ACO) is a not-for-profit organisation in Australia committed to improving the eye health and well-being of Australian communities. Established in 1940, the ACO delivers 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.

<span class="mw-page-title-main">Farnsworth–Munsell 100 hue test</span>

The Farnsworth–Munsell 100 Hue Color Vision test is a color vision test often used to test for color blindness. The system was developed by Dean Farnsworth in the 1940s and it tests the ability to isolate and arrange minute differences in various color targets with constant value and chroma that cover all the visual hues described by the Munsell color system. There are several variations of the test, one featuring 100 color hues and one featuring 15 color hues. Originally taken in an analog environment with physical hue tiles, the test is now taken from computer consoles. An accurate quantification of color vision accuracy is particularly important to designers, photographers and colorists, who all rely on accurate color vision to produce quality content.

<span class="mw-page-title-main">Vernier acuity</span>

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.

<span class="mw-page-title-main">Prism cover test</span>

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.

<span class="mw-page-title-main">Subjective refraction</span> Technique to determine the combination of lenses that will provide the best corrected visual acuity

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 vision 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.

<span class="mw-page-title-main">Louise L. Sloan</span> Vision scientist (1898-1982)

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 awarded the prestigious Edgar D. Tillyer Award by the Optical Society (OSA) 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.

References

  1. 1 2 3 4 Bailey IL, Lovie JE. I (1976.) New design principles for visual acuity letter charts. Am J Optom Physiol Opt. 53 (11): pp. 740–745.
  2. Grosvenor, Theodore (2007). Primary care Optometry. St. Louis, Missouri: ELSEVIER. pp. 174–175. ISBN   9780750675758.
  3. 1 2 "First Research starts in 1974". National Vision Research Institute. Archived from the original on 2017-07-13. Retrieved 2015-09-24.
  4. Bailey IL, Lovie JE (2013). Visual acuity testing. From the laboratory to the clinic. Vision Research 90: 2-9. doi:10.1016/j.visres.2013.05.004.
  5. Adams, Anthony J.; Lovie-Kitchin, Jan (2004). "Ian L Bailey". Clinical and Experimental Optometry. 87 (1): 37–41. doi:10.1111/j.1444-0938.2004.tb03145.x. ISSN   1444-0938. PMID   14720120. S2CID   27795798.
  6. Carlson, Kurts, Nancy, Daniel (2004). Clinical Procedures of Ocular Examination. U.S.A: McGraw HIll. p. 10. ISBN   978-0-07-137078-3.
  7. 1 2 Virgili, Gianni; Acosta, Ruthy; Bentley, Sharon A.; Giacomelli, Giovanni; Allcock, Claire; Evans, Jennifer R. (17 April 2018). "Reading aids for adults with low vision". The Cochrane Database of Systematic Reviews. 2018 (4): CD003303. doi:10.1002/14651858.CD003303.pub4. ISSN   1469-493X. PMC   6494537 . PMID   29664159.