Use of Mobile Apps for Visual Acuity Assessment: Systematic Review and Meta-analysis.

Area of Science:

• Ophthalmology
• Public Health
• Medical Technology

Background:

• Vision impairments (VIs) and blindness are significant global health concerns.
• Visual acuity (VA) testing is a cornerstone of visual function assessment in clinical settings.
• Mobile apps for VA assessment are emerging as a convenient, accessible tool for self-testing.

Purpose of the Study:

• To evaluate the accuracy and reliability of mobile applications for measuring visual acuity.
• To synthesize existing research on the diagnostic performance of smartphone and tablet-based VA tests.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed, Embase, Cochrane Library, Google Scholar) for studies published between 2008 and 2020.
• 22 studies evaluating mobile VA assessment apps were included, with 6 undergoing meta-analysis.
• Data analyzed included sensitivity, specificity, and accuracy, stratified by age group, examiner type, and device.

Main Results:

• Meta-analysis of 24,284 participants revealed high pooled sensitivity and specificity for VA apps across age groups (3-5, 6-22, 55+ years).
• Nonprofessional examiners demonstrated higher accuracy (AUC 0.93) compared to professional examiners (AUC 0.87).
• Smartphone-based apps showed strong performance (sensitivity 0.86, specificity 0.91).

Conclusions:

• Mobile app-based VA tests demonstrate significant diagnostic value for on-demand vision impairment detection.
• These apps offer a promising, accessible solution for widespread vision screening and monitoring.
• Further research can refine app-based VA testing for diverse populations and clinical integration.