Visual acuity

Definition

Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an examinee’s ability to recognize small details with precision. Visual acuity is dependent on optical and neural factors, i.e., the sharpness of the retinal image within the eye, the health and functioning of the retina, and the sensitivity of the interpretative faculty of the brain.

Eye examination for visual acuity

Visual acuity is a measure of the spatial resolution of the visual processing system. VA is tested by requiring the person whose vision is being tested to identify so-called optotypes – stylized letters, Landolt rings, pediatric symbols, symbols for the illiterate, standardized Cyrillic letters in the Golovin–Sivtsev table, or other patterns – on a printed chart from a set viewing distance. Optotypes are represented as black symbols against a white background (i.e. at maximum contrast). The distance between the person’s eyes and the testing chart is set so as to approximate “optical infinity” in the way the lens attempts to focus (far acuity), or at a defined reading distance (near acuity).

Measurement

Visual acuity is measured by a psychophysical procedure and as such relates the physical characteristics of a stimulus to a subject’s percept and his/her resulting responses. Measurement can be by using an eye chart invented by Ferdinand Monoyer, by optical instruments, or by computerized tests like the FrACT.

Care must be taken that viewing conditions correspond to the standard, such as correct illumination of the room and the eye chart, correct viewing distance, enough time for responding, error allowance, and so forth. In European countries, these conditions are standardized by the European norm (EN ISO 8596, previously DIN 58220).

Physiology

Daylight vision (i.e. photopic vision) is subserved by cone receptor cells which have high spatial density (in the central fovea) and allow high acuity of 6/6 or better. In low light (i.e., scotopic vision), cones do not have sufficient sensitivity and vision is subserved by rods. Spatial resolution is then much lower. This is due to spatial summation of rods, i.e. a number of rods merge into a bipolar cell, in turn connecting to a ganglion cell, and the resulting unit for resolution is large, and acuity small. Note that there are no rods in the very center of the visual field and highest performance in low light is achieved in near peripheral vision

Measurement considerations

Visual acuity measurement involves more than being able to see the optotypes. The patient should be cooperative, understand the optotypes, be able to communicate with the physician, and many more factors. If any of these factors is missing, then the measurement will not represent the patient’s real visual acuity.

Motion acuity

The eye has acuity limits for detecting motion. Forward motion is limited by the subtended angular velocity detection threshold (SAVT), and horizontal and vertical motion acuity are limited by lateral motion thresholds. The lateral motion limit is generally below the looming motion limit, and for an object of a given size, lateral motion becomes the more insightful of the two, once the observer moves sufficiently far away from the path of travel.

Source: Wikipedia – January 2021.

Clarification: This text is an excerpt from a published Wikipedia article.