Video Guide: Alaska Blind Child Discovery Test Flip Book (ABCD) – Developed by Dr. Robert Arnold, MD

The ABCD Testing Framework

Adapting state-of-the-art principles for pediatric acuity testing, the ABCD configuration suggested an advanced modification of Wendy Marsh-Tootle’s Surround HOTV 10-foot test card. The ABCD HOTV card presents 4 optotypes down to a 20/16 range, whereas Dr. Tootle’s template stopped at 20/20.

The matching card features surrounded letters to avoid crowding confusion, a “spectacle-delineated” pinhole enhancement, and an HOTV near card that resembles Paul Runge’s near system but is adapted to just 10 inches—found to more accurately approximate a child’s natural lap-reading distance. The 10-foot distance and 10-inch near point are quickly demarcated by detachable measuring strings. Age-appropriate screening cut-offs (20/40 for K and below, 20/32 for older than K) are located instantly by offset index tabs. This chart has been deployed extensively with objective screening methods in the Anchorage School District.

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Chat with our specialists and pick up a complimentary Conversion Card. Quickly convert contrast values, ICD-9 and ICD-10 vision loss reporting values, as well as worldwide notations with this handy pocket card.

Q: What is Normal Vision?

A: “Normal” visual acuity for healthy eyes is one or two lines better than 20/20. In population samples, the average acuity does not drop down to the 20/20 level until age 60 or 70. Always remember that the 20/20 reference standard does not refer to the average acuity of American eyes, just as the US standard foot is defined completely independently of the “normal” length of American feet.