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Real-World Application of Home Visual Acuity Testing for Pediatric Teleophthalmology During the COVID-19 Pandemic
Insights
Home visual acuity testing during teleophthalmology consultations showed moderate accuracy in pediatric patients. This method is more reliable for older children, while younger children require in-person assessments for precise visual acuity measurement.
Area of Science:
- Ophthalmology
- Telemedicine
- Pediatric Care
Background:
- Teleophthalmology consultations became essential during the COVID-19 pandemic.
- Accurate visual acuity assessment is crucial for pediatric eye care.
- Home-based testing offers a potential solution for remote consultations.
Purpose of the Study:
- To evaluate the accuracy of home visual acuity testing in pediatric patients during teleophthalmology consultations.
- To compare home-based visual acuity findings with subsequent in-person assessments.
- To determine the reliability of home visual acuity testing across different pediatric age groups.
Main Methods:
- Retrospective study of pediatric patients undergoing teleophthalmology.
- Comparison of home visual acuity findings with in-person assessments.
- Analysis of agreement and correlation between the two testing methods.
Main Results:
- A moderate correlation (0.56) was found between home and in-person visual acuity assessments.
- Accuracy was higher in older children (correlation of 0.70 in those 8+ years).
- Correlation was lower in younger children (0.46 in those <5 years).
Conclusions:
- Home visual acuity testing during teleophthalmology is more valuable for older pediatric patients.
- In-person assessment remains the gold standard for determining visual acuity.
- Further research is needed to optimize home-based visual acuity assessment methods, especially for young children.
Purpose:
To review the ability of home visual acuity testing during teleophthalmology consultations to accurately assess visual acuity in pediatric patients in a real-world setting.
Methods:
This was a retrospective study of pediatric patients who were examined via teleophthalmology consultation due to the coronavirus disease 2019 (COVID-19) pandemic-related community restrictions between May and June 2020 at a single private ophthalmology practice. Home visual acuity findings were compared with the subsequent in-person assessment to determine agreement between measures.
Results:
Forty-three patients (86 eyes) were included in the study. The mean patient age at the time of teleophthalmology assessment was 75.9 months (range: 29 to 173 months). The correlation between home visual acuity findings and subsequent in-person assessment across all participants was 0.56 (P < .001). The upper and lower limits of agreement were 0.38 logarithm of the minimum angle of resolution (logMAR) units and -0.33 logMAR. The correlation reduced to 0.46 (P = .013) in patients younger than 5 years and increased to 0.70 (P < .001) in patients 8 years and older.
Conclusions:
Home visual acuity assessment for teleophthalmology is of increased clinical value in older pediatric patients. In-person assessment by a trained clinician is the optimal method to determine visual acuity. Because home visual acuity assessment may be necessitated by local and global factors, further research is required regarding the optimal methods for assessment, particularly in younger patients. [.
