Super acuity testing shows promise for screening hyperopia in adolescents and young adults.

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medRxiv Published April 28, 2026 Medically reviewed April 28, 2026 Study authors: Hagen, L. A.; Svarverud, E.; Krastina, I.; MacKenzie, G.; Baraas, R. C. DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider super acuity testing as a potential screening indicator for hyperopia in adolescents and young adults.

This cohort study assessed the repeatability and diagnostic utility of a super acuity test chart measurement among adolescents and young adults. The population included 41 university students aged 19 to 26 years and 119 high school students aged 16 to 18 years. Comparators included distance visual acuity, cycloplegic refractive errors, ocular biometry, accommodation, age, and sex. No adverse events or discontinuations were reported, and tolerability was not reported.

Mean super acuity in the university cohort was 0.14 +/- 0.13 logMAR, while the high school cohort had a mean of 0.12 +/- 0.11 logMAR. Repeatability of super acuity was 0.031. Super acuity was poorer in uncorrected hyperopia compared to others, with a P value of 0.039. Significant associations were observed between super acuity and positive ametropia (P = 0.026), accommodation amplitude (P < 0.001), axial length (P = 0.013), male sex (P < 0.001), and age (P = 0.037). At a threshold of 0.09 logMAR, sensitivity for detecting hyperopia with a spherical equivalent refractive error >= 1.00 D was 63.2%, and specificity was 64.2%.

Key limitations include the need for further studies to optimize the test and testing protocol, as well as the need to assess its ability to detect uncorrected hyperopia in children. The study was observational, and causality was not reported. Funding or conflicts of interest were not reported. The super acuity prototype shows promise as a screening indicator for hyperopia.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

Purpose: To assess the repeatability of a prototype super acuity test chart for measuring visual acuity at 12.5 cm, and its ability to detect hyperopia in adolescents and young adults. Methods: Repeatability was estimated as within-subject standard deviation of three repeated super acuity measurements performed in 41 university students (19-26 years). Associations between super acuity and cycloplegic refractive errors, ocular biometry, distance visual acuity, accommodation, age, and sex were assessed in 119 high school students (16-18 years) using linear mixed-effects models. ROC curves and Youden index were used to estimate the best super acuity thresholds to detect rest hyperopia. Results: Mean super acuities in the university and high school cohorts were 0.14 {+/-} 0.13 and 0.12 {+/-} 0.11 logMAR, respectively. Repeatability was 0.031. Super acuity was poorer in those with uncorrected hyperopia [spherical equivalent refractive error (SER) [≥] 1.00 D] than the others [SER < 1.00 D; P = 0.039]. There were significant associations between poorer super acuity and more positive ametropia (SER; P = 0.026), poorer accommodation amplitude (P < 0.001), shorter axial length (P = 0.013), male sex (P < 0.001), and age (P = 0.037). Sensitivity and specificity for detecting hyperopia (SER [≥] 1.00 D) were 63.2% and 64.2%, respectively, at a super acuity threshold of 0.09 logMAR. Discussion: The super acuity prototype shows promise as a screening indicator for hyperopia. Further studies are needed to optimize the test and testing protocol, and to assess its ability to detect uncorrected hyperopia in children.