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https://robertlederman.com Many clinicians are told that accurate visual acuity can’t be measured until a child knows letters or numbers. Many clinicians are told that accurate visual acuity can’t be measured until a child knows letters or numbers. That simply isn’t true. In this video, I walk through practical, reliable ways of assessing vision in children — and in adults who cannot easily communicate — by adapting the test to the patient, rather than forcing the patient to adapt to the test. I cover: • Using Lea symbols for distance and near acuity • Matching tasks when naming isn’t possible • Preferential looking with Cardiff Cards • Measuring amplitude of accommodation with appropriate near targets • Choosing the right fixation target for cover testing • Maintaining attention without over-demanding the patient These approaches are not about doing more testing. They’re about clearer thinking and better alignment with the person in front of you. When we adapt our testing to the patient’s world, we get better information — and parents notice. If you’d like to explore this kind of clinical thinking in more depth, I also run a free webinar where I unpack how to interpret common tests more clearly and confidently. Details are available via the website above. You’re welcome to subscribe for more clinical insights like this. --- 00:00 Why acuity testing doesn’t require letters or numbers 00:33 Lea Symbols for distance acuity and matching 01:58 Adapting tests for children and special needs patients 02:01 Cardiff Cards and preferential looking acuity 03:46 Using Lea symbols for near acuity and accommodation 04:52 Measuring amplitude of accommodation accurately 05:02 Choosing the right target for the cover test 05:49 Maintaining attention during binocular testing 06:27 Adapting testing to the patient’s world 06:40 Why parents notice — and why it matters ---