Among the many picture-like symbols for testing pediatrics, the Patti Pics are the only ones that have been designed explicitly to equal Sloan letters as used in ETDRS charts. We have now developed a fifth symbol for the Patti Pics test which, like the other vision symbols all blur equally at threshold. This fifth symbol improves confidence in test results by reducing the element of guessing correct answers from 25% to 20% per symbol.