Evaluation of a Home-Printable Vision Screening Test for Telemedicine

Crossland, Michael D.; Dekker, Tessa M.; Hancox, Joanne; Lisi, Matteo; Wemyss, Thomas A; Thomas, Peter

doi:10.1001/jamaophthalmol.2020.5972

Cited by 23 publications

(32 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The mean difference in VA for their patients was −0.10 logMAR (SD 0.17, range −0.5 to 0.3) with the office test indicating better vision than home assessment. 7 In contrast, our study found similar results between the tests (mean difference −0.02 logMAR, SD 0.15). A limitation of their study was the long duration between office and home assessment (mean of 12 months, range 1–69 months), during which vision may have deteriorated.…”

Section: Discussionsupporting

confidence: 67%

“…Our study found similar results compared to Crossland et al’s paper, which also evaluated office-based versus home self-assessment using a printable home vision test. 7 They evaluated patients from adult strabismus and low vision clinics. The mean difference in VA for their patients was −0.10 logMAR (SD 0.17, range −0.5 to 0.3) with the office test indicating better vision than home assessment.…”

Section: Discussionmentioning

confidence: 99%

“… 7 They demonstrated a mean difference in vision of 1 line on a vision chart (0.1 logarithm of the Minimal Angle of Resolution [logMAR], SD 0.17) between the Home Acuity Test and the last in-office vision assessment (mean of 1 year) for ophthalmology outpatients in their strabismus and low vision clinics. 7 One of the limitations was a long lag time between the last in-office visit and home VA assessment of 12 months (range 1–69 months). 7 …”

Section: Introductionmentioning

confidence: 99%

“… 7 One of the limitations was a long lag time between the last in-office visit and home VA assessment of 12 months (range 1–69 months). 7 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparing a Home Vision Self-Assessment Test to Office-Based Snellen Visual Acuity

Chen¹,

Li²,

Schallhorn³

et al. 2021

OPTH

View full text Add to dashboard Cite

Purpose To evaluate the agreement of a home vision screening test compared to standard in-office technician-measured Snellen visual acuity to allow for remote screening and triaging of patients. Patients and Methods In this prospective study, English-speaking patients with in-office ophthalmology appointments from May to August 2020 and visual acuity better than 20/125 were asked to complete a home vision test one week before their scheduled in-office appointment. The home vision test was a modified ETDRS chart displayed in a PDF document that could be printed or viewed on a monitor. The primary outcome was the mean difference between office-based and home visual acuity. Results Eighty-two eyes of 45 patients were included in the study with 45 study eyes analyzed. The mean difference between office-based and home visual acuity was −0.02 logMAR (SD 0.15, P =0.28) among study eyes. Of these eyes, 91% demonstrated agreement between the two methods within 0.2 logMAR of the mean difference, and 60% had agreement within 0.1 logMAR of the mean difference. There were no significant demographic or ocular risk factors leading to a greater difference between the tests. Conclusion There was good agreement between the home and in-office Snellen tests for patients with vision better than 20/125. The home vision test can be used to remotely determine if there is a significant vision change of >0.2 logMAR or approximately 2 lines of visual acuity.

show abstract

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 7 One of the limitations was a long lag time between the last in-office visit and home VA assessment of 12 months (range 1–69 months). 7 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparing a Home Vision Self-Assessment Test to Office-Based Snellen Visual Acuity

Chen¹,

Li²,

Schallhorn³

et al. 2021

OPTH

View full text Add to dashboard Cite

show abstract

“…Capacity is more severely limited by social distancing as all patients will attend clinics accompanied by an adult. Although a gamut of teleophthalmology solutions, including remote vision testing, has been trialled and rolled out with moderate degrees of success in adult ophthalmology subspecialties (Bourdon et al 2020;Gillam et al 2020;Kang et al 2020;Kilduff et al 2020;Mintz et al 2020;Crossland et al 2021;Faes et al 2021), it may be more difficult to adapt these to the paediatric population. Our paper reveals a striking statistic: when triaging cancelled outpatient appointments during the first peak at AHCH, only 6.8% were deemed to be suitable for a telephone or video consultation.…”

Section: Discussionmentioning

confidence: 99%

The Impact of the First Peak of the COVID-19 Pandemic on a Paediatric Ophthalmology Service in the United Kingdom: Experience from Alder Hey Children’s Hospital

Wood¹,

Gray²,

Raj³

et al. 2021

British and Irish Orthoptic Journal

View full text Add to dashboard Cite

Objective: The COVID-19 pandemic has led to significant service loss across the NHS, and ophthalmology is one of the greatest affected specialties. We attempt to quantify the impact of the first peak of the COVID-19 pandemic on a paediatric ophthalmology unit in a children's hospital in the United Kingdom (UK) and report lessons learnt to aid in the recovery of the service. Methods and Analysis:Two eight-week periods of clinical activity were compared; one during the first UK peak of the COVID-19 pandemic and the other during a similar period the previous year. Four areas of clinical activity were included in the study: outpatient clinic appointments, theatre activity, outpatient referrals to ophthalmology and ward reviews. Appointment data was collected from departmental databases.Results: During the first peak of the pandemic, outpatient clinic appointments were reduced by 87.2%, ophthalmic surgery by 90.9%, outpatient referrals to ophthalmology by 50.2% and ward reviews by 50%. The number of actual cancelled appointments was 1377, of which 6.8% were triaged as suitable for teleophthalmology. Conclusion:The COVID-19 pandemic has dramatically restricted clinical activity in the ophthalmology service. Paediatric ophthalmology is vulnerable to capacity issues and the consequences of delayed or cancelled appointments. Departments must adapt quickly and maximise capacity to help reduce the backlog and treat patients effectively and safely. Solutions such as teleophthalmology have potential although can be difficult in the paediatric population.

show abstract

Validation of Home Visual Acuity Tests for Telehealth in the COVID-19 Era

et al. 2022

View full text Add to dashboard Cite

uring the initial portion of the COVID-19 pandemic, eye care professionals needed to reduce the risk of exposure to patients while continuing to provide highquality health care. The Casey Eye Institute at Oregon Health and Science University saw a decrease in clinic visits to 25% of prepandemic levels in April 2020 and did not return to baseline until March 2021. 1 With the need to limit clinic visits and an increase in the Centers for Medicare & Medicaid reimbursement for telehealth services, 2 teleophthalmology has played a critical role in responding to the COVID-19 pandemic. 1,3,4 Although published data are limited regarding teleophthalmology during the pandemic, a study looking at ophthalmology visits insured by Blue Cross Blue Shield of Michigan found a 4-fold increase in virtual visits compared with baseline data from the first 3 months of the pandemic. 5 A study at Casey Eye Institute demonstrated positive clinician attitudes with telehealth implementation during the pandemic 1 ; however, access to an easy-to-use, validated at-home visual acuity (VA) test for adults limited telehealth care.With increased use of telehealth technology, it is crucial to ensure that quality of care remains optimal. A key factor in evaluating and treating patients during eye care visits is the VA measurement. During a clinical encounter, this measurement is taken at specific distances using standardized charts, including Snellen, Early Treatment Diabetic Retinopathy Study (ETDRS), HOTV, and Tumbling E charts. 6 Historically, VA test-IMPORTANCE Visual acuity (VA) is one of the most important clinical data points in ophthalmology. However, few options for validated at-home VA assessments are currently available.OBJECTIVE To validate 3 at-home visual acuity tests in comparison with in-office visual acuity.DESIGN, SETTING, AND PARTICIPANTS Between July 2020 and April 2021, eligible participants with VA of 20/200 or better were recruited from 4 university-based ophthalmology clinics (comprehensive, cornea, glaucoma, and retina clinics). Participants were prospectively randomized to self-administer 2 of 3 at-home VA tests (printed chart, mobile phone app, and website) within 3 days before their standard-of-care clinic visit. Participants completed a survey assessing usability of the at-home tests. At the clinic visit, best-corrected Snellen distance acuity was measured as the reference standard. MAIN OUTCOMES AND MEASURESThe at-home VA test results were compared with the in-office VA test results using paired and unpaired t tests, Pearson correlation coefficients, analysis of variance, χ 2 tests, and Cohen κ agreement. The sensitivity, specificity, positive predictive value, and negative predictive value of each at-home test were calculated to detect significant VA changes (Ն0.2 logMAR) from the in-office baseline. RESULTSA total of 121 participants with a mean (SD) age of 63.8 (13.0) years completed the study. The mean in-office VA was 0.11 logMAR (Snellen equivalent 20/25) with similar numbers of participants from the 4 clinics....

show abstract

Evaluation of a Home-Printable Vision Screening Test for Telemedicine

Cited by 23 publications

References 26 publications

Comparing a Home Vision Self-Assessment Test to Office-Based Snellen Visual Acuity

Comparing a Home Vision Self-Assessment Test to Office-Based Snellen Visual Acuity

The Impact of the First Peak of the COVID-19 Pandemic on a Paediatric Ophthalmology Service in the United Kingdom: Experience from Alder Hey Children’s Hospital

Validation of Home Visual Acuity Tests for Telehealth in the COVID-19 Era

Contact Info

Product

Resources

About