Validity and feasibility of a self-administered home vision examination in Yueqing, China: a cross-sectional study

Abstract

ObjectiveTo investigate the validity and feasibility of a self-administered home vision examination programme in China.DesignCross-sectional study.SettingYueqing, China.ParticipantsA two-stage convenience sampling procedure was used to randomly select 600 households from 30 communities participating in the Yueqing Eye Study (YES). The aim of YES is to encourage home-based vision screening, reporting of visual acuity (VA) annually through social media and encouraging people to attend follow-up clinic appointments as a way to improve eye care access for adults with VA ≤+0.5 log of the minimum angle of resolution (logMAR).InterventionsHousehold screeners (one per household) who tested other family members’ VA completed a questionnaire on family structure, demographic information and knowledge about screening procedures. Other family members then underwent confirmatory VA testing by researchers.Outcome measuresThe completion rate of home-based VA screening, its sensitivity and specificity were used to evaluate validity. Factors that determined whether families participated in the self-VA screening were used to evaluate feasibility.Results345 (66%) of the 523 (87.2%) households with valid data form their home-based vision examinations also were retested by researchers. There was no statistically significant difference in scores on the family-administerd or researcher-administerd VA test (VA≤+0.5 logMAR, p=0.607; VA >+0.5 logMAR, p=0.612). The sensitivity and specificity of home-based vision screening were 80.5% (95% CI 70.2% to 86.9%) and 95.1% (95% CI 92.6% to 96.8%), respectively. 14.7% (77/523) of tested respondents had VA ≤+0.5 logMAR. Predictors of performing home screening for VA remaining in regression models included higher economic status (‘fair and above’ vs ‘poor’: OR 1.74; 95% CI 1.08 to 2.76; p=0.022), age (<45 years vs ≥45 years: OR 0.46; 95% CI 0.25 to 0.85; p=0.014) and living in a nuclear (OR 5.17; 95% CI 2.86 to 9.36; p<0.001) or extended family (OR 8.37; 95% CI 4.93 to 14.20; p<0.001).ConclusionSelf-administered home vision screening is reliable and highly accepted by Chinese adults.

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

“…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 . Historically, VA testing has been done exclusively in a clinical setting under the guidance of a trained professional, but in recent years, various options have been created for testing outside of the clinic, including paper charts, web-based tests, and smartphone applications …”

“…ing has been done exclusively in a clinical setting under the guidance of a trained professional, but in recent years, various options have been created for testing outside of the clinic, including paper charts, [7][8][9][10] web-based tests, [11][12][13][14] and smartphone applications. [15][16][17][18][19][20][21][22][23][24] Many commercially available VA tests are not validated before public release, and many applications require users to pay a fee, making clinical application unrealistic for some patients.…”

“…16 A significant barrier to implementation of these new VA tests is translation to at-home use, as many of the studies were performed in the clinical or research setting 11,17,18 and used trained staff to administer the tests. 7,12,15,16,[19][20][21][22]26 These study designs pose significant constraints on the ability to extrapolate the findings to the real-world conditions of selfadministered VA testing at home. A few recent studies have validated paper chart acuity tests [8][9][10] and a web-based test 14 under home conditions.…”

Visual Screening in Eye Health Promotion of School Children in Aracaju-Se

“…In addition, the implementation of visual screening protocols in primary health care is the most effective way to detect children who have the potential for visual impairment in a period still possible for effective treatment (NYE, 2014;GE, 2020). However, the implementation of national public policies for children's eye health care in a legalized way is still part of future commitments by the regulatory and representative bodies of Brazilian Ophthalmology (OTTAIANO, 2019).…”