The paper presents a brief overview and analysis of various approaches to assessment of visual acuity (VA). It aims to
explicate the reasons of disparity of opinions among experts on the methods of assessing VA by reflecting on advantages
and shortcomings of individual methods and the corresponding VA notations. In the course of time, the number of methods
and procedures of VA assessing was increasing; they became more diverse and complex. In parallel, the number of
professionals who assessed VA for different purposes was also increasing. Such state of affairs has resulted in certain
difference between the views on the interpretation of outcomes of VA measurement and to introducing different VA
notations. Currently, however, reaching a consensus among experts is becoming crucial since numerous research projects
require cooperation of professionals from different areas and, also, involve international collaboration. In search of
the common ground for the consensus and the unified terminology and notation, it is reasonable to appraise the crux of
the VA assessment problem and, as well, rationales for a great variety of current viewpoints on solving the problem in
practice. An overview of contemporary approaches to assessment of VA points out that there exists the sole primary
measure of VA that can be obtained by a direct measurement and expressed by the base unit of spatial metrics – the
minimum angle of resolution (MAR, αm) – defined as the minimum angle at which two points are just perceived as separate.
There exists one more measure, in place of MAR, – the critical spatial frequency (Fc) – which can be gauged directly
when one employs gratings of varying spatial frequency to estimate the maximum (critical) spatial frequency above which
periods of a grating can no longer be distinguished. It is reasonable to consider all other VA measures as secondary, or
derived, since these are calculated as functions of α m. Introduction of various secondary measures, such as Snellen
fraction, decimal units, logMAR, visual efficiency (VE), visual acuity rating (VAR), and others, was stipulated by the
demand of developing alternative notations of VA, which are more convenient and comprehensible, than αm, for
practitioners who assess VA in applied areas for various purposes, such as screening, diagnostics, monitoring,
rehabilitation, disability determination, population statistical evaluations, designing of new VA tests, etc. We
conclude that, in view of substantial differences of the purposes, requirements and criteria among experts in various
areas, the quest for a unique measure of VA, which would be optimal in all contexts, is probably unresolvable, as is
establishing of the ultimate, “gold standard”, practical method of VA assessment.
Key words:
human vision, visual acuity, scales of measurement, MAR, Snellen fraction, decimal units, logMAR, VAR
DOI: 10.31857/S0235009221030033
Cite:
Rozhkova G. I., Gracheva M. A., Paramei G. V.
An overview of the visual acuity assessment. 1. primary measures and various notations.
Sensornye sistemy [Sensory systems].
2021.
V. 35(3).
P. 179–198. doi: 10.31857/S0235009221030033
References:
- Altman D.G., Gore S.M., Gardner M.J., Pocock S.J. Statistical guidelines for contributors to medical journals. Annals of Clinical Biochemistry. 1992. V. 29 (1). P. 1–8. https://doi.org/10.1177/000456329202900101
- Anderson R.S., Thibos L.N. Sampling limits and critical bandwidth for letter discrimination in peripheral vision. Journal of the Optical Society of America A. 1999. V. 16 (10). P. 2334–2342. https://doi.org/10.1364/JOSAA.16.002334
- Artal P. Optics of the eye and its impact in vision: a tutorial. Advances in Optics and Photonics. 2014. V. 6 (3). P. 340–367. https://doi.org/10.1364/AOP.6.000340
- Artal P., Chen L., Fernández E.J., Singer B., Manzanera S., Williams D.R. Neural compensation for the eye’s optical aberrations. Journal of Vision. 2004. V. 4 (4). P. 281–287. https://doi.org/10.1167/4.4.4
- Bach M. The Freiburg Visual Acuity test –Automatic measurement of visual acuity. Optometry and Vision Science. 1996. V. 73 (1). P. 49–53. https://doi.org/10.1097/00006324-199601000-00008
- Bach M. The Freiburg Visual Acuity Test-Variability unchanged by post-hoc re-analysis. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2007. V. 245 (7). P. 965–971. https://doi.org/10.1007/s00417-006-0474-4
- Bailey I.L., Lovie J.E. New design principles for visual acuity letter charts. American Journal of Optometry and Physiological Optics. 1976. V. 53 (11). P. 740–745. https://doi.org/10.1097/00006324-197611000-00006
- Bailey I.L., Lovie-Kitchin J.E. Visual acuity testing. From the laboratory to the clinic. Vision Research. 2013. V. 90. P. 2–9. https://doi.org/10.1016/j.visres.2013.05.004
- Beck R.W., Moke P.S., Turpin A.H., Ferris III, F.L., SanGiovanni J.P., Johnson C.A., Birch E.E., Chandler D.L., Cox T., Blair C., Kraker, R.T. A computerized method of visual acuity testing: adaptation of the early treatment of diabetic retinopathy study testing protocol. American Journal of Ophthalmology. 2003. V. 135 (2). P. 194–205. https://doi.org/10.1016/S0002-9394(02)01825-1
- Bohigian G.M. An ancient eye test–using the stars. Survey of Ophthalmology. 2008. V. 53 (5). P. 536–539. https://doi.org/10.1016/j.survophthal.2008.06.009
- Bondarko V.M., Danilova M.V., Krasil’nikov N.N., Leushina L.I., Nevskaya A.A., Shelepin Yu.E. Prostranstvennoe zrenie [Spatial vision]. St. Petersburg: Nauka. 1999. 218 p. (in Russian).
- Bourne R.R.A., Rosser D.A., Sukudom P., Dineen B., Laidlaw D.A.H., Johnson G.J., Murdoch J.E. Evaluating a new logMAR chart designed to improve visual acuity assessment in population-based surveys. Eye. 2003. V. 17. P. 754–758. https://doi.org/10.1038/sj.eye.6700500
- Campbell F.W., Green D.G. Optical and retinal factors affecting visual resolution. The Journal of Physiology. 1965. V. 181 (3). P. 576–593. https://doi.org/10.1113/jphysiol.1965.sp007784
- Campbell F.W., Robson J.G. Application of Fourier analysis to the visibility of gratings. The Journal of Physiology. 1968. V. 197 (3). P. 551–566. https://doi.org/10.1113/jphysiol.1968.sp008574
- Carkeet A. Modeling logMAR visual acuity scores: effects of termination rules and alternative forced-choice options. Optometry and Vision Science. 2001. V. 78. P. 529–538. https://doi.org/10.1097/00006324-200107000-00017
- Cole B.L. Measuring visual acuity is not as simple as it seems. Clinical and Experimental Optometry. 2014. V. 97. P. 1–2. https://doi.org/10.1111/cxo.12123
- Colenbrander A. Measuring vision and vision loss. In Tasman W., Jaeger E.A. (Eds.), Duane’s clinical ophthalmology. Vol. 5 (Ch. 51). Philadelphia, PA: Lippincott Williams & Wilkins. 2001. P. 2–42.
- Colenbrander A. The historical evolution of visual acuity measurement. Visual Impairment Research. 2008. V. 10 (2–3). P. 57–66. https://doi.org/10.1080/1388235080263240
- Curcio C.A., Sloan K.R., Kalina R.E., Hendrickson A.E. Human photoreceptor topography. The Journal of Comparative Neurology. 1990. V. 292 (4). P. 497–523. https://doi.org/10.1002/cne.902920402
- Duncan R.O., Boynton G.M. Cortical magnification within human primary visual cortex correlates with acuity thresholds. Neuron. 2003. V. 38 (4). P. 659–671. https://doi.org/10.1016/S0896-6273(03)00265-4
- Elliott D.B. The good (logMAR), the bad (Snellen) and the ugly (BCVA, number of letters read) of visual acuity measurement. Ophthalmic and Physiological Optics. 2016. V. 36 (4). P. 355–358. https://doi.org/10.1111/opo.12310
- Elliott D.B., Sheridan M. The use of accurate visual acuity measurements in clinical anti-cataract formulation trials. Ophthalmic and Physiological Optics. 1988. V. 8 (4). P. 397–401. https://doi.org/10.1111/j.1475-1313.1988.tb01176.x
- Ferris F.L., Kassoff A., Bresnick G.H., Bailey I.L. New visual acuity charts for clinical research. American Journal of Ophthalmology. 1982. V. 94 (1). P. 91–96. https://doi.org/10.1016/S0896-6273(03)00265-4
- Golovin S.S., Sivtsev D.A. Tablitsy dlya issledovaniya ostroty zreniya [Charts for measurement of visual acuity]. Moscow: Gosidatel’stvo; 1926 (in Russian).
- Gracheva M.A., Kazakova A.A., Pokrovskiy D.F., Medvedev I.B. Tablitsy dlya otsenki ostroty zreniya: analiticheskii obzor, osnovnye terminy [Visual acuity charts: analytical review, basic terms]. Annals of the Russian Academy of Medical Sciences. 2019. V. 74 (3). P. 192–199 (in Russian) https://doi.org/10.15690/vramn1142
- Green J. On a new series of test-letters for determining the acuteness of vision. Transactions of the American Ophthalmological Society. 1868. V. 1 (4–5). P. 68–71.
- Green J. Notes on the clinical determination of the acuteness of vision, including the construction and graduation of optotypes, and on systems of notation. Transactions of the American Ophthalmological Society. 1905. V. 10 (3). P. 644–654.
- Gregory N.Z., Feuer W.F., Rosenfeld P.J. Novel method for analyzing Snellen visual acuity measurements. Retina. 2010. V. 30 (7). P. 1046–1050. https://doi.org/10.1097/IAE.0b013e3181d87e04
- Hecht S., Mintz E.U. The visibility of single lines at various illuminations and the retinal basis of visual resolution. Journal of General Physiology. 1939. V. 22 (5). P. 593–612. https://doi.org/10.1085/jgp.22.5.593
- Heinrich S.P., Bach M. Resolution acuity versus recognition acuity with Landolt-style optotypes. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2013. V. 251 (9). P. 2235–2241. https://doi.org/10.1007/s00417-013-2404-6
- Helmzoltz H.L.F. Handbuch der physiologischen Optic. 1867. L. Voss: Leipzig (in German).
- Helmholtz H.L.F. Helmholtz’ treatise on physiological optics. Trans. From third German ed., ed. by J.P.C. Southall, published by Optical Society of America. 3 vols. Menasha, WI: G. Banta Co. 1924–1925.
- Heron G., Furby H.P., Walker R.J., Lane C.S., Judge O.J.E. Relationship between visual acuity and observation distance. Ophthalmic and Physiological Optics. 1995. V. 15 (1). P. 23–30. https://doi.org/10.1046/j.1475-1313.1995.9592788.x
- Holladay J.T. Proper method for calculating average visual acuity. Journal of Refractive Surgery. 1997. V. 13 (4). P. 388–391. https://doi.org/10.3928/1081-597X-19970701-16
- Hyon J.Y., Yeo H.E., Seo J.M., Lee I.B., Lee J.H., Hwang J.M. Objective measurement of distance visual acuity determined by computerized optokinetic nystagmus test. Investigative Ophthalmology & Visual Science. 2010. V. 51 (2). P. 752–757. https://doi.org/10.1167/iovs.09-4362
- International Vocabulary of Metrology – Basic and General Concepts and Associated Terms (3rd ed.), Joint Committee for Guides in Metrology. 2008. P. 6 http://www.bipm.org/utils/common/documents/jcgm/ JCGM_200_2008.pdf (accessed on 08.01.2021)
- Jerri A.J. The Shannon sampling theorem – its various extensions and applications: A tutorial review. Proceedings of the IEEE. 1977. V. 65 (11). P. 1565–1596. https://doi.org/10.1109/PROC.1977.10771
- Kaido M., Dogru M., Ishida R., Tsubota K. Concept of functional visual acuity and its applications. Cornea. 2007. V. 26. P. S29–S35. https://doi.org/10.1097/ICO.0b013e31812f6913
- Kholina A. Novaya tablitsa dlya issledovaniya ostroty zreniya [A new chart for assessment of visual acuity]. Russkii oftal’mologicheskii zhurnal. 1930. V. 11 (1). P. 42–47 (in Russian).
- Koskin S.A. Sistema opredeleniya ostroty zreniya v tselyakh vrachebnoi ekspertizy [A system of determining visual acuity for medical expertise]. MD thesis. St. Petersburg. 2009. 48 p. (in Russian).
- Lennie P., Van Hemel S.B. (Eds.). Visual impairments: Determining eligibility for social security benefits. Washington, DC: National Academies Press. 2002. https://doi.org/10.17226/10320
- Lovie-Kitchin J.E. Validity and reliability of visual acuity measurements. Ophthalmic and Physiological Optics.1988. V. 8 (4). P. 363–370. https://doi.org/10.1111/j.1475-1313.1988.tb01170.x
- Lovie-Kitchin J.E., Brown B. Repeatability and intercorrelations of standard vision tests as a function of age. Optometry and Vision Science. 2000. V. 77 (8). P. 412–420. https://doi.org/10.1097/00006324-200008000-00008
- Miller W.H., Bernard G.D. Averaging over the foveal receptor aperture curtails aliasing. Vision Research. 1983. V. 23 (12). P. 1365–1369. https://doi.org/10.1016/0042-6989(83)90147-5
- Monoyer F. Échelle typographique décimauex pour mesurer l’acuité visuelle. 1875. Gazette Médicale de Paris. V. 21. 258–259 (in French).
- Ogle K.N. On the problem of an international nomenclature for designating visual acuity. American Journal of Ophthalmology. 1953. 36 (7). P. 909–921. https://doi.org/10.1016/0002-9394(53)92172-2
- Pfeiffer R.L. Frans Cornelis Donders Dutch physiologist and ophthalmologist. Bulletin of the New York Academy of Medicine. 1936. V. 12 (10). P. 566–581.
- Pirenne M.H. Visual acuity. In H. Davson (Ed.), The eye. Vol. 2: The visual process. New York/London: Academic Press. 1962. P. 175–195. https://doi.org/10.1016/B978-1-4832-3089-4.50018-2
- Plainis S., Tzatzala P., Orphanos Y., Tsilimbaris M.K. A modified ETDRS visual acuity chart for Europeanwide use. Optometry and Vision Science. 2007. V. 84 (7). P. 647–653. https://doi.org/10.1097/OPX.0b013e3180dc9a60
- Polyak S.L. The retina: The anatomy and the histology of the retina in man, ape, and monkey, including the consideration of visual functions, the history of physiological optics, and the histological laboratory technique. Chicago: University of Chicago Press. 1941. 607 p.
- Porter J., Queener H., Lin J., Thorn K., Awwal A.A.S. (Eds.). Adaptive optics for vision science: principles, practices, design, and applications. New York: Wiley. 2006. 595 p.
- Putnam N.M., Hofer H.J., Doble N., Chen L., Carroll J., Williams D.R. The locus of fixation and the foveal cone mosaic. Journal of Vision. 2005. V. 5 (7). P. 632–639. https://doi.org/10.1167/5.7.3
- Radner W. Reading charts in ophthalmology. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2017. V. 255 (8). P. 1465–1482. https://doi.org/10.1007/s00417-017-3659-0
- Rayleigh L. Investigations in optics, with special reference to the spectroscope. Philosophical Magazine. 1879. V. 8 (49): 261–274. https://doi.org/10.1080/14786447908639684
- Roorda A., Williams D.R. The arrangement of the three cone classes in the living human eye. Nature. 1999. V. 397 (6719). P. 520–522. https://doi.org/10.1038/17383
- Roorda A., Romero-Borja F., Donnelly W.J., Queener H., Hebert T.J., Campbell M.C. Adaptive optics scanning laser ophthalmoscopy. Optics Express. 2002. V. 10 (9). P. 405–412. https://doi.org/10.1364/OE.10.000405
- Roslyakov V.A. Novye tablitsy dlya izmereniya ostroty zreniya [New charts for visual acuity assessment]. Rossiiskii oftal’mologicheskii zhurnal. 2001. (1). P. 36–38 (in Russian).
- Rosser D.A., Cousens S., Murdoch I.E., Fitzke F.W., Laidlaw D.A. How sensitive to clinical change are ETDRS logMAR visual acuity measurements? Investigative Ophthalmology & Visual Science. 2003. V. 44 (8). P. 3278–3281. https://doi.org/10.1167/iovs.02-1100
- Rozhkova G.I. LogMAR dlya ostroty zreniya khuzhe, chem loshadinaya sila dlya moshchnosti elektricheskoi lampochki [LogMAR is worse for visual acuity than horsepower for electric lamp]. Sensornye sistemy [Sensory Systems]. 2017. V. 31 (1). P. 31–43 (in Russian).
- Rozhkova G.I. Est’li real’nye osnovanija sčitat’ tablicy ETDRS “zolotym standartom” dlja izmerenij ostroty zrenija? [Are there true reasons to consider ETDRS charts as a “golden standard” for measuring visual acuity?] Russian Military Medical Academy Reports. 2018. V. 37 (2). P. 120–123 (in Russian).
- Rozhkova G.I., Malykh T.B. Sovremennye aspekty standartizacii vizometrii [Current issues of standardization in visometry]. Aviakosmicheskaya i ekologicheskaya meditsina. 2017. V. 51 (6). P. 5–16 (in Russian). https://doi.org/10.21687/0233-528X-2017-51-6-5-16
- Rozhkova G.I., Matveev S.G. Zrenie detei: problemy otsenki i funktsional’noi korrektsii [Vision in children: Problems of the assessment and functional correction]. Moscow: Nauka, 2007. 315 p. (in Russian).
- Rozhkova G.I., Tokareva V.S., Vaschenko D.I., Vasiljeva N.N. Vozrastnaya dinamika ostroty zreniya u shkol’nikov. I.Binokulyarnaya ostrota zreniya dlya dali [Age dynamics of visual acuity in schoolchildren. I. Binocular visual acuity for far distance]. Sensornye sistemy [Sensory Systems]. 2001. V. 15 (1). P. 47–52 (in Russian).
- Rozhkova G.I., Tokareva V.S., Nikolaev D.P., Ognivov V.V. Osnovnye tipy zavisimosti ostroty zreniya ot rasstoyaniya u cheloveka v raznom vozraste po rezul’tatam diskriminantnogo analiza [Main types of dependence of visual acuity on the distance in individuals of different age based on discriminant analysis results]. Sensornye sistemy [Sensory Systems]. 2004. V. 18 (4). P. 330–338 (in Russian).
- Rozhkova G.I., Podugolnikova T.A., Vasiljeva N.N. Visual acuity in 5–7-year-old children: Individual variability and dependence on observation distance. Ophthalmic and Physiological Optics. 2005. V. 26. P. 66–80. https://doi.org/10.1111/j.1475-1313.2004.00263.x
- Shamshinova A.M., Volkov V.V. Funktsional’nye metody issledovaniya v oftal’mologii [Functional methods of investigation in ophthalmology]. Moscow: Nauka. 1999. 416 p. (in Russian).
- Siderov J., Tiu A.L. Variability of measurements of visual acuity in a large eye clinic. Acta Ophthalmologica Scandinavica. 1999. V. 77. P. 673–676. https://doi.org/10.1034/j.1600-0420.1999.770613.x
- Sloan L.L. Needs for precise measures of acuity: Equipment to meet these needs. Archives of Ophthalmology. 1980. V. 98 (2). P. 286–290. https://doi.org/10.1001/archopht.1980.01020030282008
- Snell A.C., Sterling S. The percentage evaluation of macular vision. Transactions of the American Ophthalmological Society. 1925. V. 23. P. 204–227.
- Snellen H., Graham C.H. Probebuchstaben zur Bestimmung der Sehschärfe [Test letters for determining visual acuity]. Utrecht: Van de Weijer. 1862. 19 p. (in German).
- Snyder A.W., Miller W.H. Photoreceptor diameter and spacing for highest resolving power. Journal of the Optical Society of America. 1977. V. 67 (5). P. 696–698. https://doi.org/10.1364/JOSA.67.000696
- Somov E.E. Metody oftal’moergonimiki [Methods of ophthalmoergonomics]. Leningrad: Nauka, 1989. 157 p. (in Russian).
- Stiers P., Vanderkelen R., Vandenbussche E. Optotype and grating visual acuity in preschool children. Investigative Ophthalmology & Visual Science. 2003. V. 44 (9). P. 4123–4130. https://doi.org/10.1167/iovs.02-0739
- Stiers P., Vanderkelen R., Vandenbussche E. Optotype and grating visual acuity in patients with ocular and cerebral visual impairment. Investigative Ophthalmology & Visual Science. 2004. V. 45 (12). P. 4333–4339. https://doi.org/10.1167/iovs.03-0822
- Stevens S.S. On the theory of scales of measurement. Science. 1946. V. 103 (2684). P. 677–680. https://doi.org/10.1126/science.103.2684.677
- Strasburger H., Bach M., Heinrich S. P. Blur unblurred – A mini tutorial. i-Perception. 2018. V. 9 (2). P. 1–15. https://doi.org/10.1177/2041669518765850
- Stulova A.N., Semenova N.S., Akopyan V.S. Otsenka ostroty zreniya: vzglyad v proshloe i sovremennye tendentsii [Visual acuity assessment: historical overview and current trends]. Vestnik oftal’mologii. 2019. V. 135 (6). P. 141–146 (in Russian). https://doi.org/10.17116/oftalma2019135061141
- Sturm V., Cassel D., Eizenman M. Objective estimation of visual acuity with preferential looking. Investigative Ophthalmology & Visual Science. 2011. V. 52 (2). P. 708–713. https://doi.org/10.1167/iovs.09-4911
- Taylor M.M., Creelman C.D. PEST: Efficient Estimates on Probability Functions. The Journal of the Acoustical Society of America. 1967. V. 41 (4A). P. 782–787. https://doi.org/10.1121/1.1910407
- Tehrani N.M., Riazi-Esfahani H., Jafarzadehpur E., Mirzajani A., Talebi H., Amini A., Mazloumi M., Roohipoor R., Riazi-Esfahani M. Multifocal electroretinogram in diabetic macular edema; correlation with visual acuity and optical coherence tomography. Journal of Ophthalmic & Vision Research. 2015. V. 10 (2). P. 165–171. https://doi.org/10.4103/2008-322X.163773
- Teller D. The forced-choice preferential looking procedure: A psychophysical technique for use in human infants. Infant Behavior & Development. 1979. V. 2. P. 135–153. https://doi.org/10.1016/S0163-6383(79)80016-8
- Teller D. The first glances: The vision of infants. Investigative Ophthalmology & Visual Science. 1997. V. 38 (11). P. 2183–2203.
- Terekhin A.P., Gracheva M.A., Rozhkova G.I., Lebedev D.S. Svidetel’stvo 2015616714 Rossiiskaya Federatsiya. [Certificate of the state registration of a computer program. Interactive program for visual acuity assessment based on the accurate threshold measurement using three optotypes “Tip-Top”]; the applicant and copyright holder: A.A. Kharkevich FGBU IPPI RAN (RU). – No.2014619697; submitted: 26.09.2014; published: 19.06.2015. (in Russian). iitp.ru/ru/patents/1293.htm
- Thorn F., Schwartz F. Effects of dioptric blur on Snellen and grating acuity. Optometry and Vision Science. V. 67 (1). P. 3–7. https://doi.org/10.1097/00006324-199001000-00002
- Tsou B.C., Bressler N.M. Visual acuity reporting in clinical research publications. JAMA Ophthalmology. 2017. V. 135 (6). P. 651–653. https://doi.org/10.1001/jamaophthalmol.2017.0932
- Vital-Durand F., Ayzac L., Pinzaru G. Acuity cards and the determination of risk factors in 6-8 months infants. In F. Vital-Durand, J. Atkinson, O.J. Braddick (Eds.), Infant vision. New York: Oxford University Press. 1996. P. 185–200.
- Watson A.B., Pelli D.G. QUEST: A general multidimensional bayesian adaptive psychometric method. Perception & Psychophysics. 1983. V. 33 (2). P. 113–120. https://doi.org/10.1167/17.3.10
- Wertheim T. Üeber die indirekte Sehschärfe [On indirect visual acuity]. Zeitschrift für Psychologie & Physiologie der Sinnesorgane. 1894. V. 7. P. 172–187 (in German).
- Wesemann W. Die Grenzen der Sehschärfe, Teil 6: Welche Sehschärfe erreicht der Mensch? [The limits of visual acuity, Part 6: What is the best visual acuity in possible in a human being?]. Optometrie. 2003. (2). P. 42–47 (in German).
- Westheimer G. Image quality in the human eye. Optica Acta. 1970. V. 17 (9). P. 641–658. https://doi.org/10.1080/713818355
- Westheimer G. Visual acuity and hyperacuity. Investigative Ophthalmology & Visual Science. 1975. V. 14 (8). P. 570–572.
- Westheimer G. Scaling of visual acuity measurements. Archives of Ophthalmology. 1979. V. 97 (2). P. 327–330. https://doi.org/10.1001/archopht.1979.01020010173020
- Westheimer G. Updating the classical approach to visual acuity. Clinical and Experimental Optometry. 2001. V. 84 (5). P. 258–263. https://doi.org/10.1111/j.1444-0938.2001.tb05035.x
- Westheimer G. Visual acuity and hyperacuity. In M. Bass, C. DeCusalis, J.M. Enoch, V. Lakshminarayanan, G. Li, C.A. MacDonald, V.N. Mahajan, E. Van Stryland (Eds.), Handbook of optics, 3rd ed. Vision and vision optics. 2010. V. 3. P. 41–417. New York: McGraw-Hill.
- Williams M.A., Moutray T.N., Jackson A.J. Uniformity of visual acuity measures in published studies. Investigative Ophthalmology & Visual Science. 2008. V. 49 (10). P. 4321–4327. https://doi.org/10.1167/iovs.07-0511
- Wolin L.R., Dillman A. Objective measurement of visual acuity: Using optokinetic nystagmus and electro-oculography. Archives of Ophthalmology. 1964. V. 71 (6). P. 822–826. https://doi.org/10.1001/archopht.1964.00970010838008
- Woodhouse J.M., Morjaria S.A., Adler P.M. Acuity measurements in adult subjects using a preferential looking test. Ophthalmic and Physiological Optics. 2007. V. 27 (1). P. 54–59. https://doi.org/10.1111/j.1475-1313.2006.00454.x
- Zheng X., Xu G., Zhang K., Liang R., Yan W., Tian P., Jia Y., Zhang S., Du C. Assessment of human visual acuity using visual evoked potential: A review. Sensors (Switzerland). 2020. V. 20 (19). P. 1–26. https://doi.org/10.3390/s20195542