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Alaska Blind Child Discovery

A cooperative, charitable research project to vision screen every preschool Alaskan

ABCD Precision Vision Chart

    Precision Vision has worked with ABCD to create an AAP-guideline consistent Surround HOTV chart with easy tabs for critical line, but also threshold acuity plus a near chart and pinhole to reduce expensive over-referral. cat #2021    
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  Preparation for Acuity Testing:
#1. Determine if child has spectacles; test with glasses but allow peaking past glasses.
#2 Familiarize patient with Surround HOTV Matching Card
#3 patch non tested eye
#4 Extend cord full 10 feet (or pre-measure and mark distance)
Critical Line Screening: (faster; 20/40 under age 6, 20/30 over age 6)
#5 Screen children Kindergarten and younger with 20/40 tab. Older than Kindergarten with 20/30 tab. They must pass 3 of 4 randomly presented surround HOTV letters from a distance of ten feet (6 meters).
#6 If unable to pass one eye, or both eyes, employ the “Enhancements to reduce False Positive Referrals (below)
Acuity Threshold Protocol:
#5 Start with 20/40 tabbed page- if passed proceed to 20/32, 20/25, and eventually 20/16.
#6 If 20/40 failed, then restart at 20/100.
#7 If unable to pass one eye, or both eyes, employ the “Enhancements to reduce False Positive Referrals (below)
#8 Test last “passed” screen 2-3 more pages. Record acuity as smallest line with 3 of 4 correct.
#9 Patch other eye and repeat steps 3-8.
Refer if inter eye difference of 2 lines or less than 20/40 Kindergarten and younger or 20/30 first grade and older.
Enhancements to Reduce False Positive Referral urgency:
If unable to pass Critical Line, then test pinhole which simulates glasses; if failed then test near. If both eyes fail, then test with no patch (binocular). Children who fail critical line, but pass pinhole and/or near need not be referred as urgently.
The ABCD Flip Card is calibrated with logMAR increments including 20/16, 20/32 and 20/64 but the Tabs are designated to allow non-confusing 20/30 critical line.
Visit for more specific instructions and demonstration video.
ABCD and Dr. Arnold make no money on the sale of these.


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