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This paper concerns the design, production and application of visual acuity tests for pre-literate children from different cultural groups. It presents a comparative analysis of the most common and relevant tests, based on information gathered in a multidisciplinary approach. The inadequacies of visual acuity tests currently in use in several different contexts are highlighted. A series of guidelines are presented for assessing the efficiency of different test materials and techniques, and also to provide a solid foundation from which to progress towards improving them.