Eye Chart Software for Pediatric Practices

Why pediatric acuity testing needs different tools

Children who cannot yet read letters can still have their acuity measured reliably — if you have the right optotypes. A pre-literate child can match a Lea Symbol or an HOTV letter on a lap card, point which way a Tumbling E faces, or name a picture. The problem with projector charts and single-purpose systems is that they rarely carry the full set, so the test gets improvised — and improvised tests produce measurements you cannot compare visit to visit.

There is a second, subtler issue: crowding. Amblyopic eyes typically read isolated letters better than letters in a line, so testing a suspected amblyope with single, uncrowded optotypes can overestimate acuity and hide the very deficit you are screening for. The practical answer is to present isolated optotypes when cooperation demands it, but surround them with crowding bars so the crowding effect is preserved. AcuityMaster does exactly that.

For the science behind choosing between Lea Symbols, HOTV, Tumbling E, and Landolt C — including matching-card strategy and testability by age — see our clinical guide to pediatric optotypes. This page is about the workflow.

The pediatric toolkit in AcuityMaster

• Lea Symbols, HOTV, Tumbling E, Landolt C, and pictures — switch optotypes instantly, mid-exam, when a child stops cooperating with one format
• Crowding bars — isolate a single optotype for a shy patient without losing the crowding effect that matters in amblyopia assessment
• Single-letter, single-line, and multiline modes — match the presentation to the child's attention span
• Video fixation targets — draw and hold a young child's gaze, with USB foot-pedal control so your hands stay free
• Snellen and ETDRS/LogMAR — the same lane handles the older siblings and the parents

A workflow that moves at the child's speed

The typical pediatric acuity encounter is a race against a shrinking attention span. Every second spent swapping chart cards, walking to the projector, or explaining a new task is a second of cooperation you will not get back. Because AcuityMaster is software, the whole toolkit lives behind one control panel: start with pictures, drop to a single crowded Lea Symbol when the child hesitates, flip to HOTV with a matching card for the older sibling — without anyone leaving their seat. The undockable control menu supports dual-monitor setups, so the chart fills the patient display while the technician drives from a second screen, and a USB foot pedal can run the video fixation targets hands-free.

Calibrated like adult testing, because it is testing

Pediatric charts are still angular measurements. AcuityMaster auto-calculates optotype sizes from the patient-to-screen distance you enter and is designed to the ANSI Z80.21 and ISO 8596 standards — the same rigor whether the patient is 4 or 84. For short pediatric rooms, mirror mode lets a compact space test at full optical distance; see our page on short exam lanes.

AcuityMaster for pediatric practices at a glance
Pediatric optotypes	Lea Symbols, HOTV, Tumbling E, Landolt C, pictures — all included
Amblyopia tools	Crowding bars, single-letter isolation, pinhole acuity overlay
Attention tools	Video fixation targets, USB foot-pedal compatible
Platforms	Browser-based Cloud (Mac, Windows, iPad) + Windows desktop (Legacy)
Pricing	From $249/seat/year (volume to $99); 15-day free trial, no credit card
Standards	ANSI Z80.21, ISO 8596, distance-calibrated
Built by	Mark S. Brown, MD, practicing oculoplastic surgeon

Built by a clinician who knows the squirm

AcuityMaster was built in 2012 by Mark S. Brown, MD, an oculoplastic surgeon in practice since 1998. Anyone who has tried to hold a toddler's attention through an acuity check knows why the software switches optotypes in one click and drives fixation video from a foot pedal: the exam has to move at the child's speed, not the equipment's.

Getting started

There is no pediatric add-on module and no separate SKU — every optotype above is included in every license. Explore the full feature list, check system requirements, review pricing, or answer licensing questions in the FAQ. The fastest path is simply to run it: the 15-day trial is fully functional, with every pediatric optotype enabled.