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"Smart Optometry" phone-based application as a visual acuity testing tool among pediatric population
Lina H Raffa1, Nasser T Balbaid1, Mariam M Ageel1
1From the Department of Ophthalmology (Raffa, Balbaid), King Abdulaziz University Hospital; and from Department of Ophthalmology (Ageel), Jeddah Eye Hospital, Jeddah, Kingdom of Saudi Arabia.
Insights
The "Smart Optometry" smartphone app is a reliable tool for testing children's visual acuity (VA) at home. It demonstrates good sensitivity in detecting reduced VA, especially in younger children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Digital Health
Background:
- Accurate visual acuity (VA) assessment is crucial for early detection of vision impairments in children.
- Traditional VA testing methods can be challenging in pediatric populations, necessitating innovative approaches.
Purpose of the Study:
- To validate a smartphone application for visual acuity (VA) testing in children.
- To compare VA measurements obtained via the app with standard clinical assessments performed by clinicians and caregivers.
Main Methods:
- A cohort of 100 children under 18 years old was enrolled.
- Participants were randomized to undergo either conventional VA screening or smartphone-based VA assessment.
- Both clinicians and caregivers performed assessments using the app and standard charts.
Main Results:
- The smartphone app showed minimal logMAR value differences compared to conventional distance (-0.023) and near (-0.004) VA tests.
- The app demonstrated 89.3% sensitivity in detecting subnormal VA, with higher sensitivity (up to 91.7%) in younger children.
- Good inter-rater reliability was observed between caregivers and clinicians using the app (ICC single measure: 0.77, average measure: 0.87).
Conclusions:
- The "Smart Optometry" app is a viable home-based tool for VA testing in children.
- The application exhibits good inter-rater reliability and sensitivity for detecting subnormal vision in pediatric patients.
- While effective for general VA screening, the app showed lower sensitivity in detecting amblyopia.
Objectives:
To evaluate the validity of a smartphone-based application for visual acuity (VA) testing in children and to compare parent and clinician-performed VA to standard VA assessment.
Methods:
A cohort of 100 children aged <18 years old was recruited. Subjects were randomly assigned to either start with conventional distance VA chart screening or the smartphone VA assessment twice by both the clinician and the caregiver if applicable. Near VA scores were assessed using the near vision E chart. Accuracy and reliability values were analyzed.
Results:
One hundred patients with an average age of 9.92 ± 3.0 years old were enrolled. The difference between conventional distance and application logMAR values was -0.023, and the difference between near vision and application logMAR values was -0.004. "Smart Optometry" had a sensitivity of 89.3% in detecting subnormal VA compared with conventional vision testing methods. Sensitivity in detecting subnormal VA was found to be higher in younger age groups up to 91.7% in comparison with the older age groups. The interclass correlation of application-measured VA scores by the caregivers and the clinician were 0.77 (95% CI; 0.67-0.83) using single measures and 0.87 (95%CI; 0.8-0.9) using average measures.
Conclusion:
"Smart Optometry" phone application was found to be an acceptable home-based VA testing tool with good inter-rater reliability for young children showing good sensitivity in detecting subnormal VA, but lower sensitivity in detecting amblyopia.
