Wright_Center_Pediatric_Ophthalmology_Strabismus_Wright_Figures_©

Purpose: To compare and correlate the clinical performance of Wright figures© in visual acuity assessments of pediatric patients with amblyopia to those obtained through Allen cards and Snellen letters.

Subjects and Methods: Best-corrected visual acuity of 26 amblyopic children were measured with the Wright figures©, Snellen letters, and isolated Allen optotypes, respectively. Amblyopia was defined as two lines of visual acuity difference or a visual acuity level of 20/30 or lower as determined by Snellen chart. The results were evaluated for statistical intergroup differences using the Wilks’ Lambda multivariate analysis of variance and for correlation using the Pearson correlation coefficient test.

Results: The mean age of the subjects was 8.27 _ 2.46 years (range: 5 to 15 years). The mean logMAR values for the Wright figures©, Snellen letters, and Allen optotypes were 0.40 _ 0.20, 0.47 _ 0.23, and 0.29 _ 0.28, respectively. When compared with Snellen letters, the Wright figures© correlated to a higher degree (r _ 0.46, P _ 0.001) than Allen optotypes (r _ 0.67, P _ 0.001). With a visual acuity of 20/40 or worse on Snellen letter testing, the sensitivity of Wright figures© and Allen cards in diagnosing amblyopic eyes was 87.0 and 56.5%, respectively (P _ 0.016).

Conclusions: Wright figures©, designed primarily to evaluate the vision in the preliterate pediatric population, correlate more closely to Snellen letters and have a higher rate of correctly identifying amblyopia than isolated Allen optotypes in pediatric patients.

Published in the Journal of the American Association of Pediatric Ophthalmology and Strabismus 2005;9:48-52.


Figure 4 A Left	Figure 4 A Right


Figure 4 B Left	Figure 4 B Right


Figure 4 C Left	Figure 4 C Right

FIG. 4. Allen figures on the left were photographed in focus. The same figures are shown on the right, but were photographed with a -18.00 lens in front of the camera to blur the images. Note that the Allen figures can be identified even when severely fogged. Inconsistent gap widths, relatively large dark areas in a figure (intrafigure heterogeneous contrast), and shape clues make the Allen figures identifiable even when the image is blurred.


Figure 5 A Left	Figure 5 B Left


Figure 5 B Right	Figure 5 B Right


Figure 5 C Left	Figure 5 C Right

FIG. 5. Wright figures on the left were photographed in focus. The same figures are shown on the right but were photographed with a -18.00 lens in front of the camera to blur the images. Note when fogged, the Wright figures are difficult to identify. Consistent gap widths, intrafigure contrast homogeneity, and similar figure shapes make the Wright figures hard to identify when the image is blurred.