Making better use of patients’ time: feasibility of performing self-administered vision assessments in waiting rooms

Background Patients often spend significant time in clinic waiting rooms. This study assessed the feasibility of using this “wasted” time to perform self-administered vision assessments directly within the waiting area. Methods Glaucoma patients attending routine appointments were asked to complete either a pen-and-paper (SpotChecks) or digital (PopCSF) contrast sensitivity (CS) test. Ambient illuminance, background noise, and crowd levels were recorded to assess potential environmental confounds. Test durations and patient feedback were recorded. Visual-Functioning Index-7 (VF-7) and Pelli-Robson CS (reference) test results were collected for comparison. Results Of 173 patients approached, 155 (89.6%) agreed to participate, and 151(97.4%) participants completed testing before their appointment (77/78 pen-and-paper; 74/74 digital). Environmental factors had no significant impact (all P > 0.05). Median completion times were 3.0 {2.6–4.5} minutes (pen-and-paper) and 2.5 {2.0–3.5} minutes (digital). Age did not impact the pen-and-paper test duration ( P = 0.944) but weakly correlated with the digital test duration ( r digital = 0.27, P = 0.020). Functional CS scores correlated with Pelli-Robson reference measurements ( r pen-and-paper = 0.81; r digital = 0.62 ) , age ( r pen-and-paper = –0.58 ; r digital = – 0.37), logMAR visual acuity ( r pen-and-paper = – 0.42 ; r digital = –0.44), and visual field mean deviation scores ( r pen-and-paper = –0.54 ; r digital = –0.63). Both tests were highly acceptable to patients ( > 80% on all questions). Visit durations were longer for participants (109 vs 88 min, P = 0.007), but this was attributed to consenting and related research activities rather than the tests themselves. Conclusions This proof-of-concept study demonstrates that it is feasible for patients to self-administer portable vision tests in clinic waiting rooms. Using CS as a representative example, this approach may enable additional data collection, potentially improving patient management, clinic flow, and/or patient satisfaction.