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Published on: April 28, 2020
Assessment of visual acuity in the supine position
1Department of Emergency Medicine, New York University, Bellevue Hospital Medical Center, New York 10016, USA. reess@is2.nyu.edu
Summary
A modified Snellen eye chart accurately assesses visual acuity (VA) in a supine position, showing high correlation and agreement with standard charts. This allows for earlier VA evaluation in emergency department patients.
Area of Science:
- Ophthalmology
- Emergency Medicine
- Medical Devices
Background:
- Accurate visual acuity (VA) assessment is crucial in emergency departments (EDs).
- Assessing VA in supine patients can be challenging with standard equipment.
- A modified Snellen eye chart may offer a solution for supine VA evaluation.
Purpose of the Study:
- To evaluate the accuracy of a modified, ceiling-mounted Snellen eye chart for assessing visual acuity in the supine position.
- To compare the results obtained with the modified chart against a standard Snellen eye chart.
Main Methods:
- Prospective study involving 56 ED staff volunteers.
- Comparison of visual acuity measurements using a standard Snellen chart and a size-reduced, ceiling-mounted modified Snellen chart.
- Statistical analysis included correlation coefficients (r) and weighted kappa statistics to assess agreement.
Main Results:
- Visual acuity ranged from 20/10 to 20/200, with 87% of participants achieving 20/50 or better.
- High correlation between the two charts: right eye r = 0.931, left eye r = 0.953.
- Substantial agreement was found (kappa = 0.63 right, 0.79 left), with minimal differences in readings between charts.
Conclusions:
- The modified ceiling-mounted Snellen eye chart demonstrates excellent correlation and substantial agreement with the standard chart for supine visual acuity assessment.
- This modified chart may facilitate earlier visual acuity evaluation for supine patients in the ED setting.
- Further research in diverse ophthalmological patient populations is recommended.
