HOTV may improve vision screening before age 8
Preschool screening with HOTV yielded fewer referrals and better screening performance than tumbling E, with differences diminishing with age.
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By
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Andrea Surnit
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September 9, 2026
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1
HOTV letter-matching testing may improve vision screening in children under 8 compared to tumbling E testing.
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The study included 995 children aged 3 to 15, with mean uncorrected visual acuity of 0.15 logMAR for HOTV and 0.20 logMAR for tumbling E.
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Referral rates for reduced uncorrected visual acuity were 19% with HOTV versus 31% with tumbling E among preschool children.
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HOTV demonstrated higher true-positive rates for amblyopia screening in preschool children compared to tumbling E.
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Both tests had high testability, with 95% of children completing HOTV testing and 97% completing tumbling E testing.