A behavioral method for efficient screening

of visual acuity in young infants

I. Preliminary laboratory development
Velma Dobson, Davida Y. Teller, Clifton Ping Lee, and Brenda Wade

A technique for rapid behavorial screening of grating acuity in infants 1 to 4 months of age is
described. The approach, called forced-choice preferential looking (FPL), depends upon the
fact that normal infants will stare fixedly at acuity gratings with stripe widths above a rather
abrupt cutoff width. The present task is to find the minimum stripe width, termed the diagnos-
tic stripe width, to which infants with normal visual acuity will readily respond. The expecta-
tion is that infants with below-normal acuity will not be able to respond to diagnostic stripes so
defined. To assess the feasbility of such a test procedure and define preliminary diagnostic
stripe widths for infants 4, 8, 12, and 16 weeks of age, 76 presumptively normal infants were
tested in the laboratory with a 40-trial FPL procedure. Sixty-nine infants (91%) completed the
test procedure. For each age group, a preliminary estimate of the diagnostic stripe width was
found. The group performance was uniformly high for the stripe widths designated as diagnos-
tic and fell off sharply for finer stripes, confirming the feasibility of the approach.

Key words: visual acuity, screening, human infants

M ethods for assessment of visual acuity in

infants would be useful to pediatricians and
ophthalmologists for early detection of visual
problems. Until recently, however, neither
normative infant acuity data nor clinically
applicable techniques for measuring acuity in
infants have been available.
Within the past few years, a considerable
number of studies of the course of develop-
ment of visual acuity in infants between birth
and 6 months of age have appeared. These
From the Departments of Psychology and Physiology/
Biophysics, Regional Primate Research Center, and
Child Development and Mental Retardation Center,
University of Washington, Seattle.
This research was supported in part by NSF grant
BNS76-01503 and NEI grant 5 RO1 EY01695 to
Davida Teller and by NIH Postdoctoral Research Fel-
lowship No. F22 EY01523 to Velma Dobson.
Submitted for publication March 20, 1978.
Reprint requests: Dr. Velma Dobson, Department of
Psychology, NI-25, University of Washington, Seattle,
Wash. 98195.
studies have used optokinetic nystagmus
(OKN),1"3 preferential looking (PL),4' 5 and
the visually evoked potential (VEP)6"9 to
measure acuity. Data accumulating from
many laboratories suggest that visual acuity
increases regularly with age over at least the
first 4 to 6 months postnatal. Data from dif-
ferent laboratories employing variants of the
same technique show good agreement on age
norms and age trends for group data. In ad-
dition, there is relatively low variability in
acuity values obtained from extensively
tested individual infants of a given age.'°~ la
Thus, reliable normative descriptions of the
development of visual acuity are rapidly be-
coming available. (For reviews see Dobson
and Teller.16- 17)
Recent publications have indicated that
each of the three techniques which have
been used to gather normative data in the
laboratory can be used for clinical assessment
of acuity in infants. Enoch and Rabinowicz18

1142 0146-0404/78/121142+09$00.90/0 © 1978 Assoc. for Res. in Vis. and Ophthal., Inc.

Downloaded from iovs.arvojournals.org on 03/02/2019

 Volume 17
Number 12 Infant visual acuity screening. I. Laboratory 1143

used OKN to follow the development of vi-

sual acuity in an infant subsequent to removal
of a monocular cataract. They found that
acuity development was arrested in the apha-
kic eye but began to develop along a more or
less normal time course after the fitting of a
correcting contact lens. Sokol9 has used the
VEP to assess visual acuity in two infants
seen clinically. In one infant, who had a
monocular cataract, the VEP was found to be
reduced in the affected eye. A second infant,
born 8 weeks prior to term and tested at 22
weeks postnatal, exhibited VEP responses
more similar to those of a full-term 18-
week-old infant than a full-term 22-week in-
fant. Miranda19 and Fantz et al.20 used the PL
technique to show that the development of
acuity in a group of premature infants lagged
behind the development of acuity in a group
of term infants, with a time course predicta-
ble on the basis of conceptional age. In addi-
tion, performance on a PL task has been
shown to be among the best available predic-
tors of later neurologic abnormalities in
high-risk neonates. 21 Thus, there is ample
reason to attempt development of techniques Fig. 1. Apparatus for the forced-choice preferen-
applicable to the screening of visually at-risk tial looking (FPL) procedure. The infant's fore-
infants. head is 36 cm from each stimulus position and
directly below the eye-shield. The eye-shield pre-
The present article presents the concep- vents the holder from seeing the location of the
tual framework and preliminary laboratory acuity grating. An observer is located behind the
results of a modification of the PL procedure central peephole. By looking at the infant's eye
intended for clinical use. The article that fol- and head movements, the observer must judge on
lows22 presents the results of the first clinical each trial whether the acuity grating is located on
trials using the procedure. the left or on the right. If the observer can do
better than chance for a given acuity target, it
Materials and methods follows that the infant can resolve the target.
The shadow on the screen was not present during
General procedure. A modification of the origi-
testing.
nal preferential looking (PL) technique 4 ' 23 has
been developed in our laboratory5' 24 and used to
obtain psychophysical estimates of acuity in indi- stripe widths. The percent of trials in which the
vidual infants.'"'• IZ* 14' '•"'• 2~'' 2(i In this forced-choice observer correctly judges the location of the
preferential looking (FPL) procedure, an infant is striped pattern can then be plotted as a function of
held in front of a display screen (Fig. 1). A striped the stripe width, to yield a psychometric function
acuity grating is presented in one of two possible (Fig. 3). Acuity is estimated as some point on the
positions, either at the left or at the right of the psychometric function, e.g., 75% correct by the
screen. An observer, uninformed as to the position observer. Thus, the FPL procedure results in an
of the test grating, is located behind a peephole at estimate of acuity for each infant.
the center of the screen. The observer's task is to However, two features of this procedure render
judge the position of the grating pattern on each it as yet impractical for clinical use. First, even if
trial on the basis of the infant's looking behavior the stripe widths needed to span the function can
(Fig. 2). Each infant is tested extensively, with 20 be guessed ahead of time, as they now can be for
or more trials on each of four or five different normal infants,17 a substantial number of trials at

Downloaded from iovs.arvojournals.org on 03/02/2019

 Invest. Ophthalmol. Visual Sci.
1144 Dobson et al. December 1978

Fig. 2. Observer's view of the infant through the peephole. A, Acuity grating to the observer's
left. B, Acuity grating to the observer's right.

80 MIN.OFARC
(20/1600) (SNELLEN)

I OCTAVE
STRIPE WIDTH
Fig. 3. Psychometric function for an 8-\veek-old infant tested with the FPL procedure. The
observer's percent correct is plotted as a function of the five stripe widths on which the infant
was tested. Conversions to Snellen equivalents (using the convention that 1' per stripe equals
20/20 Snellen) are given on the abscissa. The infant performed near 100% for 40' and 20'
gratings but near chance for 10' and 5' targets, with an estimated "threshold" (75%) at about
16' or 20/320 acuity.

several different stripe widths is required to obtain
a well-defined psychometric function. To obtain a
psychometric function with 20 trials per point at
five stripe widths can take from 2 to 4 hours of
testing, depending upon the infant. Second, if the
stripe widths needed to span the function cannot
be guessed a priori—and, almost by definition,
they cannot be for clinically interesting infants—
then even more stripe widths must be used. Even
with a highly efficient search strategy, many stripe
widths would have to be sampled to find and
define the function if it were in an unpredictable
location.
A procedure which should on the average be
less time consuming would be to test an infant at a
single point on the stripe-width continuum and
then use the infant's score on that stripe width as a
diagnostic indicator of whether the infant's acuity

Downloaded from iovs.arvojournals.org on 03/02/2019

 Volume 17
Number 12 Infant visual acuity screening. I. Laboratory
is normal or not. Ideally, such a diagnostic stripe
width would be selected to be large enough so that
virtually all infants with normal visual acuity could
easily detect the stripes but small enough that vir-
tually all infants with abnormally low acuity would
fail to detect them. For clinical evaluations of in-
dividual infants, in addition to using a minimal
number of trials, it is also necessary to achieve
statistically reliable results for each infant.
With these strategies in mind, we have defined
the diagnostic stripe width to be the narrowest
stripe width on which 95% of normal infants of a
given age will get 15 or more out of 20 trials cor-
rect; i.e., 75% or more correct on 20 trials.* This
value was chosen because with p = 0.5 and
n = 20, 75% correct is statistically significantly
above chance at the 0.05 level (exact binomial
test).
The present task, then, was to find and validate
diagnostic stripe widths for normal infants of vari-
ous ages.
Apparatus. The apparatus was identical to that
described by Teller et al. 5 and is shown in Fig. 1.
Basically, the apparatus consisted of a gray screen
(Crescent Cardboard No. 651) in which two 9 cm
stimulus holes and a 4 mm peephole were cut. On
each trial, an acuity grating (Biometrics Division,
Narco-Biosystems) was placed behind one stimu-
lus hole and a piece of the gray cardboard was
placed behind the other. The acuity gratings and
gray cards were embedded in a wheel mounted
behind the cardboard screen so that the position of
the stripes (left vs. right) and the size of the stripes
(control stripes vs. test stripes) could be changed
rapidly during the test session.
The acuity gratings had a nominal 1:1 duty
cycle and a nominal contrast of 82%. The space-
average luminance of the individual striped cards
ranged from 1.25 to 1.30 log cd/m 2 (measured with
an International Light IL500 Photometer) and ap-
proximately equaled the luminance of the gray
cardboard stimulus and screen (1.23 log cd/m 2 ).
*It must be emphasized that the diagnostic stripe width
is not itself an absolute measure of acuity, but falls about
1.5 octaves below the FPL acuity at each age. (See Dob-
son and Teller.17) The 1- to 1.5-octave difference be-
tween the estimated diagnostic stripe width and the av-
erage acuity found for infants of a particular age is not
surprising, given that the average psychometric function
for an individual infant typically spans about a 2-octave
range5' l4- IS (See also Fig. 3.) A stripe width 1.5 octaves
wider than that required for theshold (75% correct)
would be near the top of the psychometric function.
Thus, an infant with acuity near normal for its age would
be expected to do very well on the diagnostic stripes.
Downloaded from iovs.arvojournals.org on 03/02/2019
1145
Stripe widths of the grating stimulus were 0.95,
0.48, 0.32, 0.24, and 0.12 cm, which correspond
to approximately 80', 40', 27', 20', and 10' of vi-
sual angle, respectively, for an infant held at the
test distance of 36 ± 3 cm from the centers of the
two stimulus positions. Conversions to Snellen
equivalents are given in Fig. 3.
Three adults are required to test an infant: the
observer, who observes the infant and judges the
position of the striped card on each trial; the
holder, who holds the infant but cannot see the
stimulus display (Fig. 1); and the experimenter,
who sets up the trials, records the observer's
judgments, and provides trial-by-trial feedback to
the observer.
Subjects. Subjects were solicited by letters to
parents listed in the birth announcements section
of the newspaper and were paid $5.00 for the test
session. Fourteen 4-week-old, twenty-one 8-
week-old, nineteen 12-week-old, and twenty-two
16-week-old infants were tested. All infants were
born within 10 days of their due date, as reported
by the parents, and each was tested at a single age,
within 3 days of his or her fourth-, eighth-,
twelfth-, or sixteenth-week birthday.
Selection of stimuli. The goal of the study was to
estimate, to one octave* or better, the diagnostic
stripe width, i.e., the smallest stripe width on
which 95% of infants with normal visual acuity
would perform significantly above chance. There-
fore, for each age it was necessary (1) to find a
stripe width on which virtually all infants would
perform significantly above chance in 20 trials and
(2) to show that a substantial fraction of normal
infants would fail to perform significantly above
chance on a stripe width finer by 1 octave or less.
Intuition and previous experience in testing in-
fants5' l5 (Fig. 3) led us to use 40' and 20', 27' and
20', 20' and 10', and 20' and 10' test stripes for 4-,
8-, 12-, and 16-week infants, respectively. Each
infant was tested with only one of the two test
stripe widths selected for his or her age group.
In addition to the test stripes, every infant was
tested with a set of large, readily resolvable con-
trol stripes, of 80' subtense. The control stripes
were intended to serve two purposes. First, they
helped keep the infant interested in the proce-
dure. Second, they indicated whether poor per-
formance by an infant on the test stripes (if it oc-
curred) was due to a behavioral problem, e.g.,
fussiness or drowsiness, or to limited acuity. High
*An octave is a halving or doubling of stripe width or
spatial frequency, and a halving or doubling of the de-
nominator in Snellen notation (Fig. 3).
 Invest. Ophthalmol. Visual Sri.
1146 Dobson et al. December 1978

Name Holder

Birthdate Observer

Date Experimenter

SCORING + = observer's judgment correct o = observer's judgment Incorrect

Trial 1 2 3 4 5 6 7 8 9 10
Grating 1600 1600 1600 1600 1600 1600 1600 1600 1600 1600
Position R L R R L R L R L L
Score

if 4/5 or 5/5 ^" go to trial 1, next line

Trial 1 2 3 4 5 6 7 8 9 10
Grating
D D 1600 D 1600 D D 1600 D D
Position R L R R L L L R L R

Score

T if 5/5, quit

Trial 11 12 13 14 15 16 17 18 19 20

Grating D 1600 D D 1600 D 1600 D D D

Position R L R L R L L L R L

Score

f if 9/10, quit

Trial 21 22 23 24 25 26 27 28 29 30

Grating 1600 1600 D D 1600 D D 1600 D D

Position R R R L R L R L L R

Score

if 13/15, quit if/15/20,

Total Correct: 20/1600_ quit
Diagnostic ( )
IMPRESSION:

Fig. 4. Scoresheet containing one of the orders of trials used for testing an infant with the
diagnostic stripe width. On the first trials, large control stripes are presented to allow the
infant to become familiar with the procedure and the observer to become familiar with the
infant's looking pattern. The final 30 trials are a mixture of 10 control stripes and 20 diagnostic
stripes. The size of the diagnostic stripe width used depends on the age of the infant. In the
present study, all 40 trials were used. Arrows indicate a set of possible cutoff points of termina-
tion of testing for increased efficiency. (See discussion of rescoring.)

performance (>75% correct) on the part of the
observer on both test and control stripes was taken
to indicate both that the infant was testable and
that the test stripes could be resolved. Poor per-
formance on the test stripes but high performance
on the control stripes was taken to indicate a test-
able infant unable to resolve the test stripes. Poor
performance on both test and control stripes
(should it occur) would be taken to indicate either
an untestable infant or one with severely limited
acuity.
Procedure. Each infant received 40 trials using
the FPL procedure. The time required to com-
plete the 40 trials was recorded. A sample score

Downloaded from iovs.arvojournals.org on 03/02/2019

 Volume 17
Number 12 Infant visual acuity screening. I. Laboratory 1147

100 T

10' 80' so1

CONTROL CONTROL

STRIPE WIDTH
Fig, 5. Percent correct on test and control stripes, for infants tested in preliminary estimation
of diagnostic stripe widths. Scores of each infant on a test stripe width and on the 80' control
stripes are shown. Preliminary diagnostic stripe widths are taken to be 40', 27', 20', and 20' for
4-, 8-, 12-, and 16-week infants, respectively. The three symbols representing scores on the
control stripes indicate scores of infants who passed (scored S: 75%) on either of the two test
stripes (•) and scores of infants who failed (scored < 75% correct) on the smaller (o) or larger
(x) of the test stripes at a particular age.

sheet is shown in Fig. 4. For the first 10 trials, the
control stripes were used. These served to ac-
quaint the infant with the procedure and allowed
the observer to become familar with the infant's
looking pattern. Following these trials, the infant
received 30 trials in which 10 of the control stripes
were intermixed quasirandomly with 20 trials of
the test stripes being used for that infant. On each
trial, the observer's task was to say whether the
stripes appeared on the left or on the right side of
the screen. Trial length was variable, depending
upon the length of time the observer felt was re-
quired to make a judgment. Typically, trial length
was between 10 and 30 sec, although occasional
trials required less than 5 or more than 60 sec.
An infant's results were designated pass if he or
she scored 75% or better on the 20 test trials, and
fail if the score fell below 75%.
Testing on each potential diagnostic stripe
width was continued either until 10 infants had
been tested with that stripe width (of whom at
least eight had passed) or until three infants had
failed. In the latter case, no more infants were
tested at that stripe width, since it was unlikely to
be the diagnostic stripe width.
Results
The scores obtained by each infant on test
and control stripes are shown in Fig. 5. The
abruptness of the change in the infants' be-
havior with changes in stripe width suggests
that the concept of a diagnostic stripe width is
a meaningful one. For example, for the
4-week-old infants (Fig. 5), three out of three
infants tested with 20' stripes failed (scored
less than 75% correct), while 10 out of 10
infants tested with 40' stripes passed (scored
greater than 75% correct). These data, al-
though limited by a small sample size, sug-
gest that the diagnostic stripe width for
4-week-old infants falls between 20' and 40'.
Similarly, the data for the other age groups

Downloaded from iovs.arvojournals.org on 03/02/2019


1148 Dohson et al.
suggest diagnostic stripes between 20' and
27' for 8-week infants and stripes between
10' and 20' for 12- and 16-week infants.
Therefore, for our preliminary clinical trials,
we used 40' stripes for infants less than 7
weeks of age, 27' stripes for 8- through 11-
week infants, and 20' stripes for infants 12
through 16 weeks of age.22
The results on the control stripes for the
4-, 8-, and 12-week infants also support the
efficacy of the test procedure. For these age
groups, virtually all infants scored 85% or
above on the control stripes (mean = 95%).
This performance suggests that any failure to
perform above chance on the test stripes was
probably due to real acuity limitations rather
than insensitivity of the procedure. One 12-
week infant performed below 75% on the
control stripes; however, the fact that this in-
fant scored 95% on the 20' stripes suggests
that the test was an adequate assessment of
that infant's visual acuity.
Sixteen-week-old infants are, on the aver-
age, a little harder to test. Some of these in-
fants became fussy toward the end of testing
and objected to being held in front of the
screen. The difficulties encountered in test-
ing this age group are reflected in the rela-
tively low scores of the 16-week infants on
the control stripes (mean = 89%). Neverthe-
less, two of the three 16-week infants who
failed with the 10' stripes performed well on
the 80' stripes, suggesting that the test ade-
quately assessed their detection of the test
stripes. The third performed poorly on both,
suggesting lack of testability. The one 16-
week infant who failed on the 20' stripes
scored only 80% on the 80' stripes. By strict
usage of our scoring rules, he would be diag-
nosed as having failed on the basis of poor
acuity. However, his low performance coin-
cided with fussiness at the end of testing.
Diagnosis of limited acuity vs. untestability
would in fact have been unclear for this in-
fant, and retesting on a later date would be
indicated. (See also the results of rescoring,
below.)
Seven of seventy-five (9%) of the infants
failed to complete the test session. Sleepiness
prevented completion of testing of five in-
Downloaded from iovs.arvojournals.org on 03/02/2019
Invest. Ophthalmol. Visual Sci.
December 1978
fants, evenly distributed across ages. Two
16-week infants did not complete testing
due to fussiness. For the 69 infants who
completed all 40 test trials, the average time
required was 24 mins (SD = 10 min,
range = 10 to 45 min).
Rescoring. It was often obvious to the ob-
server that infants who were going to pass
could see the diagnostic stripes long before
the end of the 40-trial procedure. Thus, it
seemed sensible to stop testing each infant as
soon as he or she obtained a score statistically
significantly above chance. Binomial prob-
abilities indicate that the probability that an
infant who cannot see the diagnostic stripes
could obtain a score of 5/5, 7/8, 9/11, 11/14,
12/16, or 14/19 is less than 0.04, with a cu-
mulative probability of 0.088.22 If it is desired
to keep the cumulative probability at 0.05,
the cutoff criteria 5/5, 9/10, 13/15, and 15/20
may be used, for a cumulative probability of
0.050.
Rescoring the data using either set of cutoff
criteria showed that of the 46 infants who
scored significantly above chance on the 40-
trial procedure, all would have passed, and
the average number of trials required to
complete testing in these infants would have
been 20 instead of 40, with a concomitant
reduction of testing time. Of the 13 infants
who failed to score significantly above chance
on the 40-trial procedure, only one (the 16-
week-old infant who failed the 20 min stripes)
would have obtained a passing score if either
set of cutoff criteria had been used. Since this
infant's poor score on the 40-trial procedure
was primarily due to fussiness during the
latter part of the test, the results using the
cutoff criteria are probably a more accurate
indication of the infant's abilities than the re-
sults after 40 trials. Furthermore, five of the
seven infants who were eliminated from the
40-trial procedure due to sleepiness or fussi-
ness during testing would have been able to
complete the version of the procedure con-
taining the cutoff criteria. Thus, use of cutoff
criteria to shorten the 40-trial procedure does
not appear to change the conclusions drawn
about an infant's vision in the laboratory; it
merely shortens test time to one half or less
 Volume 17
Number 12 Infant visual acuity screening. I. Laboratory
for infants with good visual acuity and allows
testing of infants who would not tolerate a
longer 40-trial procedure.
Discussion
The results of the present study suggest
that it is possible to find a reliable minimum
(diagnostic) stripe width on which most in-
fants of a particular age with presumptively
normal visual acuity can quickly perform
significantly above chance during testing
with the FPL procedure. For each age
group, infants tested with the stripe width
later designated as diagnostic obtained uni-
formly high scores, while infants tested with
stripes 0.5 or 1 octave narrower showed a
much greater variability of scores.
On the basis of previous laboratory acuity
data on infants, it was possible to predict
fairly accurately which stripes would be the
diagnostic stripes. This success suggests that
our quick assessment taps a visual function
very similar to that measured in more exten-
sive FPL acuity testing. The validity of our
results is further supported by the parallel
fashion in which the size of the diagnostic
stripe widths and previously reported esti-
mates of PL acuity16* 17 change with increas-
ing age of the infant. Further, the test is re-
latively quickly accomplished, and more than
90% of the infants tested completed testing.
Thus, the technique exhibits some of the
properties of efficiency and validity necessary
for eventual usefulness in the clinical setting.
Further development of the procedure will
include several aspects. First, the size and
diversity of the sample on which the diag-
nostic stripes are selected will be increased,
and finer estimates of the diagnostic stripe
widths will be made. Second, increasingly
shorter and more efficient forms of the pro-
cedure are being developed, with the goal of
reducing the time required for screening
acuity to a maximum of 10 min. Third, mon-
ocular testing of infants would presumably be
of considerable value in early detection of
monocular problems. We are presently at-
tempting to test infants monocularly. Fourth,
infants are being tested in the Department of
Ophthalmology at Children's Hospital Medi-
Downloaded from iovs.arvojournals.org on 03/02/2019
1149
cal Center, Boston,22 in order to try the
technique in a clinical as well as a laboratory
setting. We wish to see whether infants at
risk for poor visual acuity fail to perform
significantly above chance on the diagnostic
stripes, and whether infants who perform
poorly without prior diagnosis of risk will be
found to have significant visual problems.
Finally, it should be reemphasized that the
present modification of the FPL technique is
specialized as a screening test and not as a
measure of an infant's acuity per se. That is,
each infant is tested against a single age
norm—the diagnostic stripes appropriate for
his or her age—and simply passes or fails; no
estimate of acuity is made. Acuity estimates
can be made with FPL by using several stripe
widths in random order on the same infant
and generating a psychometric function simi-
lar to that in Fig. 3, as in our usual laboratory
procedure, 5 ' 14> 15> 26 or by the use of staircase
or staircaselike procedures.12" l3> 27 Attempts
are in progress in our laboratory and in the
laboratories of others to develop a preferen-
tial looking technique that is efficient and re-
liable enough to yield useful acuity estimates
for individual infants in clinical settings.
We thank Michelle Backholm and Michael Sekel for
assistance in running subjects, and Marjorie Zachow for
secretarial assistance.
REFERENCES
1. Gorman, J. J., Cogan, D. C , and Gellis, S. S.: An
apparatus for grading the visual acuity on the basis of
optokinetic nystagmus, Pediatrics 19:1088, 1957.
2. Dayton, G. O., Jones, M. H., Aiu, P., Rawson, R.
A., Steele, B., and Rose, M.: Developmental study
of coordinated eye movements in the human infant.
I. Visual acuity in the newborn human: a study
based on induced optokinetic nystagmus recorded
by electro-oculography, Arch. Ophthalmol. 71:865,
1964.
3. Catford, G. V., and Oliver, A.: Development of vi-
sual acuity, Arch. Dis. Child. 48:47, 1973.
4. Fantz, R. L., Ordy, J. M., and Udelf, M. S.: Mat-
uration of pattern vision in infants during the first six
months, J. Comp. Physiol. Psychol. 55:907, 1962.
5. Teller, D. Y., Morse, R., Borton, R., and Regal, D.:
Visual acuity for vertical and diagnonal gratings in
human infants, Vision Res. 14:1433, 1974.
6. Harter, M. R., and Suitt, C. D.: Visually-evoked
cortical responses and pattern vision in the infant: a
longitudinal study, Psychonomic Sci. 18:235, 1970.
7. Marg, E., Freeman, D. N., Peltzman, P., and

1150 Dobson et al.
Goldstein, P. J.: Visual acuity development in
human infants: evoked potential measurements, IN-
VEST. OPHTHALMOL. 15:150, 1976.
8. Sokol, S.: Measurement of infant visual acuity from
pattern reversal evoked potentials, Vision Res.
18:33, 1978.
9. Sokol, S.: Patterned elicited ERGs and VEPs in
amblyopia and infant vision. In Armington, J.,
Krauskopf, J., and Wooten, B., editors: Visual Psy-
chophysics: Its Physiological Basis, New York,
Academic Press, Inc. (In press.)
10. Banks, M., and Salapatek, P.: Contrast sensitivity
function of the infant visual system, Vision Res.
16:867, 1976.
11. Banks, M. S., and Salapatek, P.: Acuity and contrast
sensitivity in 1-, 2-, and 3 month-old human infants,
INVEST. OPHTHALMOL. VISUAL. SCI. 17:361, 1978.
12. Atkinson, J., Braddick, O., and Moar, K.: De-
velopment of contrast sensitivity over the first three
months of life in the human infant, Vision Res.
17:1037, 1977.
13. Atkinson, J., Braddick, O., and Moar, K.: Contrast
sensitivity of the human infant for moving and static
patterns, Vision Res. 17:1045, 1977.
14. Allen, J.: Visual acuity development in human in-
fants up to 6 months of age, Thesis, University of
Washington, 1978.
15. Allen, J. A., Teller, D. Y., Mayer, D. L., and Lep-
per, K.: Development of visual acuity in human in-
fants up to 6 months of age. (In preparation.)
16. Dobson, V., and Teller, D. Y.: Assessment of visual
acuity in human infants. In Armington, J., Kraus-
kopf, J., and Wooten, B., editors: Visual Psy-
chophysics: Its Physiological Basis, New York,
Academic Press, Inc. (In press.)
17. Dobson, V., and Teller, D. Y.: Visual acuity in
human infants: A review and comparison of be-
havioral and electrophysiological studies, Vision
Res. (In press.)
18. Enoch, J. M., and Rabinowicz, I. M.: Early surgery
Downloaded from iovs.arvojournals.org on 03/02/2019
Invest. Ophthalmol. Visual Sci.
December 1978
and visual correlation of an infant bom with unilat-
eral eye lens opacity, Doc. Ophthalmol. 41:371,
1976.
19. Miranda, S.: Visual abilities and pattern preferences
of premature infants and full-term neonates, J. Exp.
Child Psychol. 10:189, 1970.
20. Fantz, R. L., Fagan, J. F., and Miranda, S. B.:
Early visual selectivity as a function of pattern vari-
ables, previous exposure, age from birth and con-
ception, and expected cognitive deficit. In Cohen,
L. B., and Salapatek, P., editors: Infant Perception:
From Sensation to Cognition. Vol. I. Basic Visual
Processes, New York, 1975, Academic Press, Inc.,
p. 249.
21. Miranda, S. B., Hack, M., Fantz, R. L., FanarofF, A.
A., and Klaus, M. H.: Neonatal pattern vision: A
predictor of future mental performance? J. Pediatr.
91:642, 1977.
22. Fulton, A. B., Manning, K. A., and Dobson, V.: A
behavioral method for efficient screening of visual
acuity in young infants. II. Clinical application, IN-
VEST. OPHTHALMOL. VISUAL SCI. 17:1151, 1978.
23. Fantz, R. L.: Pattern vision in young infants, Psy-
chol. Rec. 8:43, 1958.
24. Teller, D. Y.: The forced-choice preferential looking
procedure: A psychophysical technique for use with
human infants, Infant Behavior and Development
(In press.)
25. Atkinson, J., Braddick, O., and Braddick, F.: Acuity
and contrast sensitivity of infant vision, Nature
247:403, 1974.
26. Teller, D. Y., Allen, J. L., Regal, D. M., and
Mayer, D. L.: Astigmatism and acuity in two pri-
mate infants, INVEST. OPHTHALMOL. VISUAL SCI.
17:344, 1978.
27. Gwiazda, J., Brill, S., and Held, R.: Fast measure-
ment of visual acuity in infants from 2 weeks to 1
year of age. Presented at Association for Research in
Vision and Ophthalmology, Spring Meeting, Sara-
sota, Fla. April-May, 1978.