What question did this study set out to answer?

To validate a smartphone application for measuring visual acuity at home in children aged 3-17.5 years.

May 3, 20261 citations

At-home visual acuity in children using a custom iPhone application compared with standardized in-office visual acuity testing.

TRTawna L. RobertsSmith-Kettlewell Eye Research Institute EBErick D Bothun YZYufeng ZhuJaeb Center for Health Research

Key Points

To validate a smartphone application for measuring visual acuity at home in children aged 3-17.5 years.
452 children participated in the study.
In-office visual acuity was measured using gold-standard protocols by certified examiners.
Caregivers measured at-home visual acuity using the smartphone app.
95% of children with 20/40 or better vision were within 2 lines of the gold standard using the app at home.
66% of children with 20/50 or worse vision were within 2 lines of the gold standard at home.
Concordance with in-office testing was also high, with 98% of children with 20/40 or better vision matching the gold standard.

Abstract

PURPOSE: To validate a custom smartphone application for at-home visual acuity (VA) measurement in children. METHODS: A total of 452 children aged 3-17.5 years participated. Certified examiners measured in-office test-retest VA (logMAR) using gold-standard Amblyopia Treatment Study HOTV (3-to-6-year-olds, younger cohort) or electronic Early Treatment of Diabetic Retinopathy Study (7-to-17.5-year-olds, older cohort) protocols at 3-4.5 m and app-based VA at 1.5 m. Caregivers measured at-home app-based VA at 1.5 m. RESULTS: Comparing at-home app-based with gold-standard VA, in eyes 20/40 or better, 95% (143/151) and 93% (91/98) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = -0.03, older = -0.04; 95% limits-of-agreement half-width (LOA): younger = ±0.26, older = ±0.22). In eyes 20/50 or worse, 66% (42/64) and 75% (76/101) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = 0.11, older = 0.13, LOA: younger = ±0.50, older = ±0.51). Comparing in-office app-based VA with gold-standard VA, in eyes 20/40 or better, 98% (160/164) and 94% (99/105) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = -0.03, older = -0.03; LOA: younger = ±0.22; older = ±0.24). In eyes 20/50 or worse, 85% (60/71) and 91% (101/111) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = 0.04; older = 0.04; LOA: younger = ±0.39; older = ±0.24). For gold-standard test-retest, in eyes 20/40 or better, 99% (163/164) and 99% (104/105) of the younger and older cohorts had retest within 2 lines, respectively (mean differences: younger = 0.00; older = 0.01; LOA: younger = ±0.17; older = ±0.11). For 20/50 or worse, 92% (66/72) and 100% (111/111) in the younger and older cohorts were within 2 lines, respectively (mean differences: younger = 0.01; older = 0.02; LOA: younger = ±0.35; older = ±0.15). CONCLUSIONS: Our app demonstrated good concordance with the gold standard at home and in the office for eyes with VA of 20/40 or better. However, concordance decreased considerably for eyes with VA 20/50 or worse, particularly at home.

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Cite This Study

Roberts et al. (Wed,) studied this question.

synapsesocial.com/papers/69f6e5f38071d4f1bdfc69a6 https://doi.org/https://doi.org/10.1002/ovs2.70040

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