The measurement of visual acuity is the most commonly performed clinical procedure in optometric practice. The test is used to detect and monitor both ocular disease and refractive error, assess vision standards for various occupations/tasks, and also serves as an outcome measure in clinical trials. Despite such widespread use, significant limitations surround the use of conventional, high- contrast visual acuity charts. For example, such tests exhibit poor sensitivity to early disturbances in visual function in disease, with measurements also displaying high test variability. In this session the design of novel tests of visual acuity will be explored. Their performance will also be contrasted with that of conventional chart designs to provide an evidence-base for the accurate quantification of visual acuity clinical practice.