Evaluation of a New Method to Track Changes in Vision at Home for Children Undergoing Amblyopia Treatment

O’Connor, Anna; Waters, Martha A.; England, Laura; Milling, Ashli; Kay, Hazel

doi:10.22599/bioj.172

Cited by 6 publications

(2 citation statements)

References 23 publications

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“…There have been a variety of teams working to develop new equipment and methods of testing children’s visual acuity in a home setting. The Amblyopia Tracker App (Kay Pictures) and DigiVis are apps that attempt to control the variables of a typical visual acuity test by only allowing users to alter distance and not optotype size, and by measuring distance with a second device respectively (8,9). Both have good agreeability with clinical standard tests but further work on their utility and implementation is required.…”

Section: Discussionmentioning

confidence: 99%

Children’s visual acuity tests at home: A prospective repeated measures study

Osborne

Steele

Evans

et al. 2022

Preprint

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Background Home visual acuity tests could ease pressure on ophthalmic services by facilitating remote review of a variety of patients. Home tests may have further utility in giving service users frequent updates of vision outcomes during therapy, identifying vision problems in an asymptomatic population, and engaging stakeholders in therapy. The accuracy of home vision tests for children when completed without supervision from a professional is unknown. Methods Children attending outpatient clinics had their visual acuity measured 3 times in a randomised order at the same appointment. Once by a registered orthoptist as per standard clinical protocols, once by an orthoptist using a tablet-based visual acuity test (iSight Pro, Kay Pictures), and once by an unsupervised parent or carer using the tablet-based test. Results 42 children were recruited to the study. The mean age was 5.6 years (range 3.3 to 9.3 years). Median measurements (interquartile range) for clinical standard, orthoptic-led and parent/carer-led iSight visual acuity measurements were 0.155 (0.18), 0.180 (0.26), and 0.300 (0.33) respectively. The iSight app in the hands of parents/carers was significantly different from the standard of care measurements (P=0.009). In the hands of orthoptists, there was no significant difference between the iSight app and standard of care (P=0.551), nor was there significant difference between parents/carers using the app and orthoptists using the app (P=0.133). Conclusion This technique of unsupervised home visual acuity measures for children is not comparable to clinical measures and is unlikely to be valuable to clinical decision making and screening. Future work should focus on improving the technique through, for example, gamification of vision tests.

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Section: Discussionmentioning

confidence: 99%

Children’s visual acuity tests at home: A prospective repeated measures study

Osborne

Steele

Evans

et al. 2022

Preprint

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“…Several tests exist for home monitoring of visual acuity in children. [56][57][58] In this study, we have chosen to look at tests that measure contrast sensitivity, as we were interested in two specific populations: children receiving treatment for amblyopia and those with other vision impairments. In amblyopes, it is known that the CSF is reduced even after treatment has restored visual acuity to normal levels.…”

Section: Median (Iqr)mentioning

confidence: 99%

Can children measure their own vision? A comparison of three new contrast sensitivity tests

Crossland,

Dekker,

Dahlmann‐Noor

et al. 2023

Ophthalmic Physiologic Optic

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PurposeTo investigate the feasibility of children measuring their own contrast sensitivity using a range of tablet‐ and paper‐based tests.MethodsForty children aged 5–15 years with amblyopia (N = 10), bilateral vision impairment (N = 10) or good vision (N = 20) measured their own vision on a screen‐based optotype test (Manifold), a gamified vision test (PopCSF) and a paper‐based test (Spotchecks) in a laboratory with minimal supervision. Completion rate, test–retest repeatability, test duration and participants' preferences were recorded for each test.ResultsMost participants (36/40) were able to perform all three tests. All tests were correlated with clinically measured visual acuity and contrast sensitivity (p < 0.001). The 95% coefficient of repeatability was 0.30 dB for Manifold, 0.29 dB for PopCSF and 0.13 dB for Spotchecks. All tests differentiated between children with reduced contrast sensitivity and control participants. PopCSF and Spotchecks were also able to differentiate between children with amblyopia and those with good vision. Median test time was 152, 130 and 202 s for Manifold, PopCSF and Spotchecks, respectively. Twenty‐two participants preferred the PopCSF test, 10 preferred Spotchecks and 6 preferred Manifold. Thirty‐nine out of the 40 children (98%) said they would measure their own vision at home using at least one of these tests every month.ConclusionsChildren and young people can test their own contrast sensitivity with repeatable results. Of these three tests, the most repeatable was Spotchecks, the quickest was PopCSF and participants' favourite was PopCSF. Nearly all of the participants said they would be willing to use at least one of the three tests at home.

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Evaluation of the Amblyopia tracker app

O’Connor,

Warburton,

Farrelly-Waters

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Purpose The Amblyopia tracker app has been developed to be a tool for parents to monitor changes in vision at home during amblyopia treatment. The aims of this study were to evaluate the feasibility and repeatability of parents testing their children at home and to compare home test results to an assessment in clinic by an orthoptist. Methods Children (age < 18 years) with amblyopia (interocular acuity difference of ≥ 0.2logMAR) were recruited. Parents were asked to test their child with the app three times during a two week period followed by an online questionnaire about the usability. Participants also tested within 48 h of their appointment where the measurement was repeated by an orthoptist. Results Out of 277 potential participants contacted, 37 completed three home measurements, mean age 6.8 years (SD 2.94). Home tests comparisons were made between test two and three to ensure familiarity with the process. Paired t-tests showed no statistically significant difference for either eye or the interocular acuity difference (IAD). However, 29% had a difference in IAD of more than 0.1logMAR on repeated testing, with a maximum of 0.4logMAR difference in the IAD. Questionnaire responses from the parents who participated were predominantly positive with 97% of respondents saying they would use it if were available. Comparison of home and clinical measurements (n = 23, mean age 6.72 SD 2.60) showed no statistically significant differences for either eye or interocular acuity difference (paired t-test, p > 0.3 in all cases). Conclusion Results show no statistically significant differences for the Amblyopia tracker app when used by parents at home on repeated testing, or between the home test by a parent and the test by a clinician. However, variability in the results does indicate that further improvements are required to ensure the results can be used as a reliable clinical tool.

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Evaluation of a New Method to Track Changes in Vision at Home for Children Undergoing Amblyopia Treatment

Cited by 6 publications

References 23 publications

Children’s visual acuity tests at home: A prospective repeated measures study

Children’s visual acuity tests at home: A prospective repeated measures study

Can children measure their own vision? A comparison of three new contrast sensitivity tests

Evaluation of the Amblyopia tracker app

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