· Objective: Lea symbols can be used for measuring visual acuity in childhood. Therefore, these symbols might be useful for
early detection of amblyopia. We evaluated whether the visual acuity determined with Lea symbols (LS) corresponds to the visual
acuity determined with the Landolt-C (LC). · Patients and methods: In 55 strabismic amblyopic volunteers aged 5–59 years,
the monocular visual acuity of both eyes was determined using LC and LS. For comparison, the right eye of 20 healthy volunteers
was examined. Single optotypes (LC, LS) were used in 55 amblyopes and crowded optotypes (LC
17.2, LC
2.6, CLS) in 40 amblyopes. The luminance of the test charts was 180–200 cd/m
2, with a contrast >85%. The refraction of the subjects was corrected beforehand. · Results: In the 40 amblyopic eyes tested
under each condition, LS exceeded CLS and LC by about 1 line (dB), LC
17.2 by 2 lines and LC
2.6 by 3 lines (mean values ± SD: LS 0.62±1.8 dB, CLS 0.46±1.7 dB, LC 0.5±2.0 dB, LC
17.2 0.41±2.3 dB, LC
2.6 0.29±2.3 dB). The non-amblyopic fellow eyes and healthy eyes showed smaller differences (fellow eyes LS 1.32±1.1 dB, CLS
1.17±1.1 dB, LC 1.15±0.9 dB, LC
17.2 1.05±0.9 dB, LC
2.6 0.93±1.1 dB; healthy eyes LS 1.74±0.9 dB, CLS 1.58±0.8 dB, LC 1.48±0.6 dB, LC
17.2 1.41±0.7 dB, LC
2.6 1.32±1.1 dB). In the amblyopic eyes, the reduction of LC was more distinct than the reduction of LS. Fifty-two amblyopes
had an amblyopia >1 dB of LC, LC
17.2 and LC
2.6, while 50 had an interocular acuity difference >1 dB CLS. · Conclusions: Using Lea symbols, a recognition acuity can be determined
and amblyopia can reliably be detected. Due to their design, the Lea symbols are particularly suitable and recommendable for
application in young children. However a slight systematic difference between LS and LC has to be considered.
Received: 21 July 1999 Revised version received: 31 August 1999 Accepted: 2 September 1999