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Visual Acuity Testing for Telehealth Using Mobile Applications.

Benjamin J Steren1, Benjamin Young1, Jessica Chow1

  • 1Department of Ophthalmology and Visual Sciences, Yale School of Medicine, New Haven, Connecticut.

JAMA Ophthalmology
|January 14, 2021
PubMed
Summary
This summary is machine-generated.

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Visual acuity testing apps lack accuracy and reliability for telehealth. While some apps show accurate optotype sizes, none are suitable for remote patient evaluation, necessitating improved digital health tools.

Area of Science:

  • Ophthalmology
  • Digital Health
  • Medical Technology

Background:

  • Telemedicine has become crucial for patient-clinician interactions, especially since the COVID-19 pandemic.
  • Ophthalmology visual acuity testing applications (apps) lack verification for accuracy, validity, and reliability before public release.

Purpose of the Study:

  • To evaluate the accuracy of visual acuity testing apps.
  • To determine the suitability of these apps for telehealth applications.

Main Methods:

  • The US Apple App Store was searched for visual acuity testing apps.
  • Optotype sizes were calculated and compared to actual measured sizes on four Apple devices (iPhones and iPads).
  • No human participants were involved in this accuracy assessment.

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Main Results:

  • Mean errors on iPhones ranged from 0.2% to 109.9%, and on iPads from 0.2% to 398.1%.
  • Of six apps functional on both devices, 'Visual Acuity Charts' (0.2% error), 'Kay iSight Test Professional' (3.5% error), and 'Smart Optometry' (15.9% error) were most accurate.
  • No app demonstrated both accurate optotype size and consistent display across devices, deeming them unsuitable for telemedicine.

Conclusions:

  • Current visual acuity testing apps are not ideal for telemedicine due to inconsistencies in accuracy and display.
  • While some apps show promise, further development is needed to create reliable digital tools for remote ophthalmological assessments.
  • Improved visual acuity applications are essential for the effective expansion of telehealth services in eye care.