UW grad develops standardized acuity chart in Arabic

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By Jody Johnson-Pettit

A University of Waterloo PhD graduate has developed the world’s first standardized Arabic reading acuity chart.

Dr. Balsam Alabdulkader, who received her PhD in 2017 from the School of Optometry and Vision Science, says she was inspired to create the chart after returning to her clinical job in Riyadh, Saudi Arabia, and becoming frustrated with what was available.

“I wanted to get a standardized chart in Arabic for testing my patients. I then discovered that we don’t have one,” she says.

The new chart, developed by Dr. Alabdulkader with the help of Dr. Susan Leat, who supervised the project, is known as the Balsam Alabdulkader-Leat (BAL) chart.

It was designed based on the accepted design criteria for reading acuity charts. It will eliminate the potential for inconsistent eye results, as it addresses challenges presented by the language’s complexity.

Dr. Alabdulkader says her experience as a clinician in her home country of Saudi Arabia and education in Canada sparked the initial idea for the BAL chart.

The chart will affect the world of optometry by allowing for more effective eye care for Arabic-speaking populations globally, she says.

“I used to work at the low-vision clinic here in Saudi, before travelling to Canada to pursue my master’s degree. At that time, I never paid attention to the charts that we used at the clinic and how unstandardized they were,” Dr. Alabdulkader says.

“Other charts that I used to have in the clinic, had famous poems, sayings or Quran verses which made some patients read from their memory,” she says. “These were useless because they were not testing vision, but instead memory.”

For her master’s thesis research, Dr. Alabdulkader worked on the MNREAD chart, which is a gold standardized chart in English.

“I learned about the different standardized features of this chart, how it was developed, the importance of using standardized charts in testing patients and why using an unstandardized chart may affect testing results.”

Developing the BAL chart was no easy feat. It took around five and a half years and was full of challenges.

“The Arabic letters are complex,” says Dr. Alabdulkader, who currently works as an assistant professor at the School of Optometry at King Saud University in Riyadh.

“Unlike Roman letters where most of the letters can be fitted between two lines defined as the x-height, each Arabic character has different shapes depending on its position within the word. This made measuring the size very challenging.”

The BAL chart is now commercially available through Precision Vision and can be purchased from anywhere around the globe.

“I did not think the chart would ever be manufactured. With all the challenges I faced during my studies, I thought the project would end with insignificant results and be printed as a thesis project,” says Dr. Alabdulkader.

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