{"doi":"10.1016/j.jaapos.2020.06.003","title":"Telemedicine distance and near visual acuity tests for adults and children","abstract":"We describe a set of distance and near, adult and child, visual acuity tests for home use. The five charts are packaged in a PDF document and are also available as JPEG images that can be printed on standard letter paper or displayed on a monitor or handheld device. Adult distance visual acuity is tested using a modified ETDRS Chart R; child distance vision is tested using a similarly formatted HOTV logMAR chart. Testing distance is 5 or 10 feet, appropriate for home use. Near visual acuity is displayed in the range of J16 to J1 using random words (for adults) or in HOTV matching format (for young children). An Amsler Grid and HOTV matching card are included. The charts include a calibration circle. For those without a printer, sending a JPEG image as an email attachment initiates onscreen testing with a single click. Devices with smaller screens require an assistant to scroll through the display. The test can performed without assistance from a printed page. We describe a set of distance and near, adult and child, visual acuity tests for home use. The five charts are packaged in a PDF document and are also available as JPEG images that can be printed on standard letter paper or displayed on a monitor or handheld device. Adult distance visual acuity is tested using a modified ETDRS Chart R; child distance vision is tested using a similarly formatted HOTV logMAR chart. Testing distance is 5 or 10 feet, appropriate for home use. Near visual acuity is displayed in the range of J16 to J1 using random words (for adults) or in HOTV matching format (for young children). An Amsler Grid and HOTV matching card are included. The charts include a calibration circle. For those without a printer, sending a JPEG image as an email attachment initiates onscreen testing with a single click. Devices with smaller screens require an assistant to scroll through the display. The test can performed without assistance from a printed page. The ETDRS logMAR chart represents the gold standard in visual acuity testing,1Ferris III, F.L. Kassoff A. Bresnick G.H. Bailey I. New visual acuity charts for clinical research.Am J Ophthalmol. 1982 Jul 1; 94: 91-96Abstract Full Text PDF PubMed Google Scholar but the testing distance (20 feet) and large chart size (approximately 24 × 24 in) are impractical for display on either ANSI letter-size paper (8 ½ × 11 inches) or conventional electronic displays. Linear optotype presentation of five symbols per line requires a large display. Visual acuity testing of young children is best performed with symbols that are left-right symmetric. For shy or preverbal children, using a matching card avoids requiring the child to name the symbol.2Sheridan M.D. Vision screening of very young or handicapped children.Br Med J. 1960; 2: 453-456Crossref PubMed Scopus (39) Google Scholar Our charts were developed for a shorter testing distance (5 or 10 feet), appropriate for home use. This presents a line of 5 20/200 optotypes in landscape mode on letter paper. Conventional laser printers and flat screen displays found on mobile phones, tablets, laptop or desktop computers have sufficient pixel density for legible 20/16 symbols to be displayed at a testing distance of 5 feet. The 5-foot testing distance does have the disadvantage of being “in from infinity” approximately 1.5 meters, which can result in an individual with uncorrected myopia of 0.75 D being able to read the 20/20 line. At a testing distance of 10 feet, this potential for error drops to 1/3 D. At a testing distance of 20 feet, the error drops to approximately 1/8 D. Thus, a longer test distance decreases the potential for error, whereas a shorter distance improves testability of young children.3Vision in Preschoolers Study GroupPreschool vision screening tests administered by nurse screeners compared with lay screeners in the Vision in Preschoolers Study.Invest Ophthalmol Vis Sci. 2005; 46: 2639-2648Crossref PubMed Scopus (131) Google Scholar The design of the HOTV logMAR ch","journal":"Journal of American Association for Pediatric Ophthalmology and Strabismus","year":2020,"id":90183,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8779,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":455780,"name":"Hyun Soo Jang","orcid":null,"position":1,"is_corresponding":false},{"id":330812,"name":"Divya Ramesh","orcid":"0000-0003-1387-7832","position":2,"is_corresponding":false},{"id":455781,"name":"Maria Sandra Gonzalez Marshall","orcid":null,"position":3,"is_corresponding":false},{"id":455782,"name":"Selenne Yescas","orcid":null,"position":4,"is_corresponding":false},{"id":454921,"name":"Erin M. Harvey","orcid":"0000-0002-3472-9313","position":5,"is_corresponding":false},{"id":454920,"name":"Joseph M. Miller","orcid":"0000-0002-4545-0190","position":0,"is_corresponding":true}],"reference_count":10,"raw_metadata":null,"created_at":"2026-07-18T22:02:48.683291Z","pmid":"32739362","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}