Parental Home Vision Testing of Children During Covid-19 Pandemic

Abstract

Background: The Covid-19 pandemic necessitated social distancing restrictions, which placed limitations on access to ophthalmic care to only those who had an imminent risk of sight loss. All other face-to-face consultations were converted to telephone consultations or were postponed. We investigated whether parents were able to test their child's vision using available home vision testing applications, with an aim to aid decision making during a telephone consultation. Methods: Families with follow-up consultations at Birmingham Children's Hospital were asked to test their child's vision at home. Instructions for the use of Peek acuity, or iSight Pro, were emailed to a parent. Parents chose to use a particular app based on available devices at home. Parents were asked to test uniocular visual acuity twice. Home versus hospital acuity was correlated. Home acuity test-retest reliability was acquired. Parental feedback was obtained through questionnaires. Results: One hundred and three families were contacted, 15 families completed home vision testing. Ten families used Peek acuity, five families used iSight Pro. Uniocular visual acuity test-retest reliability was 0.03 LogMAR. Home-hospital acuity testing had a bias of 0.14 LogMAR, hospital acuity yielding a lower LogMAR score. Most families who completed testing found it easy to do; however, some struggled, and 81 families did not undertake home vision testing. Conclusions: Uptake of home vision testing was limited by parental engagement, most likely influenced by the current pandemic. Most families who undertook home vision testing were able to generate results that could be used for clinical decision making. Extending the impact of parental vision testing will require education by clinicians and further study to increase sample sizes and to improve confidence.

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

“…This is an important step given that assessment at home introduces more sources of variability. During the COVID-19 pandemic, the use of apps to assess VA at home was evaluated, but one study had a very low participation rate (only 16% of parents that gave consent to participate provided data) (Painter et al 2021), and another reported a modest correlation with clinical tests (Silverstein et al 2021). Therefore, further evaluation of the Amblyopia Tracker app is underway, with parents testing children at home and then testing repeated on return to the clinic.…”

Virtual consultation for red eye

“…17 18 In a prospective comparative study of app-based home vision testing in children, most families were able to generate results deemed useful for clinical decision making, but parental engagement was low. 19 Face and eyelid-The presence of vesicles and rashes on the face or eyelids suggest herpes simplex infection or herpes zoster ophthalmicus (if the involvement respects the midline of the face and V1 dermatomal distribution (fig 2)). 20 Presence of Hutchinson's sign (involvement of the tip or lateral aspect of the nose) suggests a higher likelihood of ocular involvement in herpes zoster ophthalmicus.…”

“…Free online mobile phone apps are available to check vision, but most of them have not gained regulatory approval 1718. In a prospective comparative study of app-based home vision testing in children, most families were able to generate results deemed useful for clinical decision making, but parental engagement was low 19…”

Home-based screening tools for amblyopia: a systematic review protocol

“…The use of home-based screening tools for amblyopia are increasingly advocated as social distancing is practised to minimise the risk of viral transmission. 19 20 Furthermore, COVID-19 related restrictions and lockdowns may have resulted in many children missing out opportunities for amblyopia screening. 19 Home-based screening may offer a solution, 21 but this has not been rigorously assessed and evaluated by systematic review.…”

“… 19 20 Furthermore, COVID-19 related restrictions and lockdowns may have resulted in many children missing out opportunities for amblyopia screening. 19 Home-based screening may offer a solution, 21 but this has not been rigorously assessed and evaluated by systematic review. Here, we propose a systematic review to evaluate home-based amblyopia screening tools.…”