This invited commentary discusses the evaluation by Wu et al. of two logMAR-based visual acuity (VA) tests—using tumbling E and HOTV optotypes—for vision screening in young children, in the context of optimizing screening accuracy for amblyopia and refractive errors.
No primary quantitative results are available from this commentary alone; the author highlights that no agreed gold standard VA test exists for children, as evidenced by 35 different optotype tests used across 46 countries in the EUSCREEN study.
This is an invited commentary, not a primary study—no original data, outcomes, or statistical results are reported. Full text of the referenced Wu et al. study is not available for review.
When conducting VA-based vision screening in children, test choice (optotype type), accurate test distance, and appropriate lighting all materially affect results. Clinicians should be aware that no gold-standard pediatric VA test currently exists, and standardization efforts remain incomplete.
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