Miniature fiber-optic pattern-reversal stimulator for determination of the visual evoked potential threshold; comparison with Snellen acuity

In this report we recommend the estimation of visual acuity by detection of the visual evoked potential (VEP) threshold, defined by the smallest visual angle of a constant check size that evokes potentials. This approach was implemented using a fiber-optic pattern-reversal stimulator placed at measured, increasing distances from the examined eye. Snellen visual acuity as determined in 113 subjects was correlated with the VEP detection threshold. A highly significant correlation was found between visual acuity and the threshold visual angle of check size in subjects whose vision was impaired due to opacity in ocular media. For any given visual acuity a somewhat wide range of threshold check sizes, typically 5- 10 min of arc was observed. Technical difficulties that need to be overcome to improve these results are discussed.