Validation of an objective visual acuity detector for visual acuity assessment in young children: a multicenter, self-controlled study

To assess the clinical applicability of the Objective Visual Acuity Detector in children aged 12 to 47 months. This multi-center, self-controlled study recruited 461 children (922 eyes) from children aged 12 to 47 months for visual acuity assessment. Statistical analyses were performed to compare the results of the Objective Visual Acuity Detector with those of the optokinetic nystagmus (OKN) instrument and the children's graphic vision chart, so as to evaluate the consistency of each detection method. Generalized estimating equations were used to account for the within-subject correlation between paired eyes. Compared with the children's graphic vision chart and the OKN instrument, the Objective Visual Acuity Detector had an overall consistency rate of 88.14%, while the OKN instrument had an overall consistency rate of 82.74%. The proportion of results with a deviation of less than two lines from the children's graphic vision chart was 94.27%, with a correlation coefficient of R = 0.755, indicating a strong positive correlation; with high overall cooperation of children, the measurability of the detector could reach 98%. In addition, this study investigated the visual acuity distribution characteristics and age-stratified visual impairment prevalence of children in Hunan region. Based on eye movement technology, the Objective Visual Acuity Detector can realize objective visual acuity assessment in young children. In clinical settings, it can facilitate effective vision screening in young children, yields objective results with high concordance to gold-standard assessment methods, and presents high measurability in this pediatric population.