Automated measurement of resolution acuity in infants using remote eye-tracking.

Purpose. To validate a novel, automated test of infant resolution acuity based on remote eye-tracking. Methods. Infants aged 2 to 12 months were tested binocularly using a new adaptive computerized test of infant vision using eye tracking (ACTIVE), and Keeler infant acuity cards (KIAC). The ACTIVE test ran automatically, using remote eye-tracking to assess whether the infant fixated a black-and-white grating of variable spatial frequency. Test-retest reliability was assessed by performing each test twice. Accuracy was assessed by comparing acuity measures across tests and with established age-norms, and by comparing low-contrast acuity estimates in adults with data reported previously. Results. All infants completed the ACTIVE test at least once. Median test duration was 101 seconds. Measured visual acuity increased with age (P 0.183). Conclusions. An adaptive computerized test of infant vision using eye-tracking provides a rapid, automated measure of resolution acuity in preverbal infants. The ACTIVE performed comparably to the current clinical gold standard (acuity cards) in terms of testability, reliability, and accuracy, and its principles can be extended to measure other visual functions