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Bright Eyes Family Vision Care in New Tampa FL
Bright Eyes Kids in Westchase Fl

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New Tampa & Westchase

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Home » Children's Vision » How do we check kids’ vision if they don’t know their letters?

How do we check kids’ vision if they don’t know their letters?

One of the most common questions I get as a pediatric optometrist is, "How do you know what kids can see if they don't know their letters for the traditional eye chart?" We have more options than you would think.

20220309 193121 b -- HOTV Chart -- This chart looks a lot like the traditional eye chart, but it only uses the four letters H, O, T, and V. Some children will name the letters where others will use a card in their lap with the four letters to match what they see on the screen. This test is great for 4-6 year olds.
-- LEA Symbols -- Here we have another chart with limited answer options, but instead of letters like HOTV, we have pictures. The choices are circle, square, house or heart. Some children are able to name the picture as they see it and others use a matching card to point to the one they see. Interestingly, some kids are capable of naming the shape, but prefer to use the matching card because they are feeling shy or nervous at their first eye exam. This test works well for many preschoolers. 20220309 193253 b
20220309 193223 b -- Broken Wheel Cards  -- Here we show the child two cards, one in which the wheels of the car are solid circles and one where the wheels are circles with an opening, like a C. As the cars' wheels get smaller, it tests a finer level of detailed vision, just like when the letters get smaller on the traditional eye chart. Some young kids are overwhelmed with four answer choices on a symbol matching test, so they are more confident with this test which has only two answer choices. We shuffle and repeat the cards several times to ensure they are not getting lucky guesses.
-- Patti Stripe Paddles -- Infants and young toddlers are shown a gray paddle and a paddle with fine black and white stripes. The child will instinctively look towards the stripes as it is more visually interesting. As the stripes get thinner, eventually the stripes appear to match the gray paddle. It is testing a finer level of detailed vision, known as grating acuity. The measurement we get from this test is helpful to understand one’s functional vision, but the numbers cannot be directly matched to optotype acuity, such as reading the letters or shapes on the chart. 20220309 193030 b


As children develop their attention and communication skills, we test them at the highest level they are capable of performing. These tests are also valuable for patients of any age with communication disorders or intellectual disabilities.

Measuring visual acuity at distance is commonly done during screenings at schools or pediatrician offices, but this is only one of 17 visual skills your child needs to be successful with school or sports. If you are concerned about your child’s vision, please come visit Dr. Beth or Dr. Nate for a comprehensive eye examination.