From the Guidelines
Yes, best corrected visual acuity (BCVA) can be greater than 1.0, as some individuals can achieve better than normal vision, such as 20/15 or 20/10, which corresponds to 1.33 or 2.0 decimal acuity 1.
Key Factors Influencing BCVA
- Perfect refractive correction
- Excellent contrast sensitivity
- Optimal pupil size
- Superior retinal and neural processing capabilities
- Age, with visual acuity typically peaking in early adulthood and gradually declining with age due to natural changes in the eye's structures
When measuring BCVA clinically, it's essential to use charts that can test beyond 1.0 to accurately capture these superior levels of vision, especially in refractive surgery evaluations or research settings, as noted in the refractive surgery preferred practice pattern 1.
Clinical Considerations
- A comprehensive medical eye evaluation is crucial to rule out any underlying pathologic conditions that may affect BCVA, even in individuals with excellent visual acuity 1.
- Cycloplegic refraction may be necessary in certain cases to ensure accurate measurement of BCVA, particularly in patients with high refractive errors or those whose symptoms are not consistent with the manifest refractive error 1.
From the Research
Best Corrected Visual Acuity (BCVA)
- BCVA is a measure of an individual's visual acuity with corrective lenses, such as glasses or contact lenses 2, 3, 4, 5, 6
- The studies provided do not directly address whether BCVA can be greater than 1.0, but they do discuss the improvement of visual acuity after various treatments, such as phakic intraocular lenses (pIOLs) and refractive lens exchange 2, 4
- In some cases, patients achieved a BCVA of 1.0 or better after treatment, but the maximum achievable BCVA is not explicitly stated 4, 6
Visual Acuity Measurements
- Visual acuity is typically measured in decimal or logMAR units, with 1.0 decimal corresponding to 20/20 vision or 0.0 logMAR 3, 6
- Some studies report visual acuity outcomes in terms of the proportion of patients achieving a certain level of visual acuity, such as 0.5 or 1.0 decimal 4, 5
- The relationship between BCVA and visual performance is complex and influenced by various factors, including residual refractive errors and spherical aberration 6
Treatment Outcomes
- The studies provided report positive outcomes for various treatments, including pIOLs, refractive lens exchange, and contact lens fitting 2, 4, 5
- These treatments can improve visual acuity and reduce refractive errors, but the maximum achievable BCVA is not explicitly stated 2, 4, 5
- Further research is needed to determine the potential for BCVA to exceed 1.0 with these or other treatments 3