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Vision Assessment of Nonverbal Patients

Correspondence: Requests for reprints should be addressed to: William V. Good, M.D., Smith-Kettlwell Eye Research Institute, 2318 Fillmore St., San Francisco, CA 94115; e-mail:good{at}ski.org

Introduction: The most important aspect of a pediatric eye exam is the quantitative measurement of visual acuity, yet many children in a pediatric practice are nonverbal or preverbal.

Methods: The clinician has a number of options for assessing vision in these children, including the central, steady, maintained technique, behavioral measurements, and electrophysiological measurements. Each of these approaches has advantages and disadvantages.

Results: All techniques for acuity measurement have their pros and cons. A newer technique, the sweep visual evoked potential (sVEP), can be used to measure different types of visual acuity (grating, vernier, contrast sensitivity) and also does not require any verbal responses.

Conclusion: Since vernier acuity offers a better approximation to Snellen acuity, the sVEP holds promise as a useful tool in the pediatric office and lab.

Key words: visual evoked potential, sweep VEP, vernier acuity, grating acuity