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Parent-administered visual acuity testing: is it reliable and can it improve office efficiency?
Evelyn A Paysse1, Larissa Camejo, Mohamed A W Hussein
1Department of Opthalmology, Cullen Eye Institute, Houston, TX, USA.
Insights
Parent-administered electronic visual acuity testing (EVA) is reliable for children. This method significantly reduces the number of optotypes needed by technicians, improving clinic efficiency.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Clinical Research
Background:
- Accurate visual acuity measurement is crucial for diagnosing and managing pediatric eye conditions.
- Traditional visual acuity testing can be time-consuming and requires trained personnel.
- Developing efficient and reliable screening tools is essential for pediatric eye care.
Purpose of the Study:
- To assess the accuracy of parent-administered visual acuity testing using the electronic visual acuity tester (EVA).
- To evaluate the potential of the EVA as a tool to enhance the efficiency of in-office visual acuity testing.
Main Methods:
- Prospective experimental study involving two parts.
- Part I: Compared parent-administered EVA results with ophthalmic technician measurements in 64 children.
- Part II: Compared visual acuity testing efficiency between a parent prescreening group and a full protocol group in 44 children.
Main Results:
- High reliability was found between parent-determined and technician-determined visual acuity scores (r = 0.91 OD, 0.81 OS).
- Parental prescreening with EVA significantly reduced optotype presentations by technicians (66% fewer for OD, 68% for OS).
- 93% of right eye and 85% of left eye parent scores were within one line of the technician's score.
Conclusions:
- Parent-administered EVA provides reliable visual acuity measurements in children.
- Parental prescreening using EVA streamlines the testing process, requiring fewer optotype presentations.
- Implementing parent-assisted EVA screening can lead to greater efficiency in clinical settings.
Purpose:
To evaluate the accuracy of a parent-administered visual acuity test, using the electronic visual acuity tester (EVA) (JAEB Center, Tampa, FL) and evaluate its use as a means to improve efficiency of office acuity testing.
Methods:
This was a prospective experimental study. Part I: Sixty-four children had their visual acuity determined using the EVA, first by their parents and then by an ophthalmic technician. Acuity scores were compared. Part II: Forty-four other children were randomly assigned to one of 2 groups. Group A (parent-prescreen) children had their visual acuity determined first by the parents using the EVA. The visual acuity result in that child was then rechecked by the technician using the Reinforcement Phase and Phase 2 of the Amblyopia Treatment Study (ATS) visual acuity testing protocol. Group B (full ATS protocol) children had their acuity determined by the technician using the full ATS protocol. The number of optotypes presented by the technician in order to determine the acuity in each group was compared.
Results:
Part I: Reliability of parent-determined visual acuity scores was high (r = 0.91 and 0.81 for right eyes (OD) and left eyes (OS), respectively), with 93% of right eye parent scores and 85% of left eye parent scores within 0.11 logarithm of minimal angle of resolution (logMAR) units (ie, within one line of vision) of the technician score. Part II: The parent prescreen group (Group A) required presentation of 66% fewer optotypes to the OD and 68% fewer optotypes to the OS than the full ATS protocol group (Group B) (OD: P = 5.4 x 10(-18); OS: P = 6.5 x 10(-18)).
Conclusions:
Visual acuity testing results by parents using the EVA are reliable. Electronic visual acuity prescreening by parents reduces the number of optotype presentations required to be shown by the technician to accurately determine acuity. Use of a parent-assisted screening system in the waiting room may translate to increased office efficiency.
