Assessment of the Catford drum in visual acuity testing and its use as a measurement of visual performance in low-vision patients.

Objective measurements of visual acuity were determined with the Catford drum in 82 eyes of patients in our Low-Vision Clinic who typically suffered from visual loss due to macular disease. The results were compared with subjective measurements of visual acuity by the Snellen chart. The findings indicated a significant overestimation of Snellen visual acuities by the Catford drum in 90.2% of eyes tested by a factor of 1.05 to 20.0, average 4.73. The correlation coefficient for the study was +0.40. This differs from the original results of Catford and Oliver in 1971. In addition, the Catford drum was used on follow-up visits in the same patients to assess 'visual performance'. The initial results showed an improvement in visual acuities when the Catford drum was used in 12 of 15 patients, while the Snellen acuities remained stable when retested after one month of basic instruction and use of standard low-vision aids. This improvement in 'Catford' acuity was by a factor of 0.3 to 10.0, average 4.08. This is thought to represent the patient's ability to learn the use of eccentric viewing or parafoveal retinal areas for vision. It confirms previous intuitive findings and helps to explain why low-vision patients seem to function at a higher level than expected from their Snellen visual acuities.