Efficacy of Peek Acuity versus ETDRS Chart for Assessment of Visual Acuity and Refractive Error

Background: The early treatment diabetic retinopathy study chart is the gold standard in visual acuity tests, was the prototype for the logarithm of the minimum angle of resolution card, which is a smartphone-based application called portable eye examination kit/peek acuity. Objective: To compare the Peek Acuity application with the early treatment diabetic retinopathy study chart in assessing visual acuity and refractive error, focusing on time efficiency, patient satisfaction, ease of use and comfort. Methodology: In this comparative cross-sectional study, the sample size taken was 58, with a 10% dropout. Two applications applied Peek acuity and diabetic retinopathy study chart assessment, 51 patients met eligibility criteria and were enrolled in the study. Both adult males and females aged 18 years and above, those with either normal vision or those with refractive errors, who were already using corrective glasses, were recruited in the study. Participants with conjunctivitis, uveitis, keratitis, or corneal ulcers or vision loss secondary to corneal opacities, cataracts, glaucoma, retinal disorders, or optic nerve pathologies, postoperative or intraoperative complications, use of mydriatic drops or undergoing refractive surgery were excluded from the study. Outcome measurement tools were the Patient Satisfaction Questionnaire Short Form, and topic-related questions were added from these two Ease of Care questionnaires for assessment of ease and comfort level and the Comfort Questionnaire. The Shapiro-Wilk test was used to check normality, showing significant p-values for all variables and non-normal distribution. Therefore, non-parametric tests were applied. The chi-square test was applied to find the Pearson correlation between different variables. Mann-Whitney U test and one-sample Wilcoxon signed-rank test were used to measure differences. Results: The chi-square test showed a significant association between gender and affected eyes and refractive error. One-sample Wilcoxon ranked test results reject the null hypothesis for all tests (p≤0.05). Conclusion: Both methods were effective in enhancing patient outcomes. However, the early treatment diabetic retinopathy study chart was associated with superior performance in terms of visual acuity accuracy and patient satisfaction, while Peek Acuity demonstrated advantages in reduced testing time and improved patient comfort and ease of use.