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Author Spotlight: An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
Published on: March 17, 2023
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At-home visual acuity in children using a custom iPhone application compared with standardized in-office visual
Tawna L Roberts1, Erick D Bothun2, Yufeng Zhu3
1Spencer Center for Vision Research, Byers Eye Institute at Stanford University, Palo Alto, California, USA.
Summary
A new smartphone app shows good accuracy for measuring children's visual acuity (VA) at 20/40 or better, both at home and in the clinic. However, accuracy decreases for poorer vision (20/50 or worse), especially with at-home testing.
Area of Science:
- Ophthalmology
- Digital Health
- Pediatric Care
Background:
- Accurate visual acuity (VA) measurement is crucial for early detection of vision disorders in children.
- Traditional methods can be time-consuming and require specialized equipment, limiting accessibility for at-home monitoring.
- Smartphone applications offer a potential solution for convenient and accessible VA testing.
Purpose of the Study:
- To validate a custom smartphone application for measuring visual acuity (VA) in children.
- To assess the app's concordance with gold-standard VA measurement methods in both at-home and in-office settings.
- To evaluate the app's performance across different age groups and levels of visual acuity.
Main Methods:
- A study involving 452 children aged 3-17.5 years.
- Comparison of app-based VA measurements (at 1.5m) with gold-standard methods (HOTV and electronic ETDRS protocols at 3-4.5m).
- Measurements were taken both in-office by examiners and at-home by caregivers.
Main Results:
- The app demonstrated good concordance with gold-standard VA for eyes with 20/40 or better vision (93-98% within 2 lines).
- Concordance decreased for eyes with 20/50 or worse vision, with 66-75% agreement in the at-home setting.
- Test-retest reliability for the gold standard was high across all VA levels.
Conclusions:
- The validated smartphone app shows promise for at-home and in-office visual acuity assessment in children with good vision (20/40 or better).
- Performance is less reliable for children with poorer visual acuity (20/50 or worse), particularly in the at-home setting.
- Further refinement may be needed to improve accuracy for children with sub-optimal vision.
