Novel, self-administered near visual acuity screener accurate, reliable vs. standard tests
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Key takeaways:
- The Hadassah Self-Visual Acuity Screener demonstrated high reliability, accuracy and alignment with standard tests.
- Results obtained using the self-administered test agreed with those of a masked examiner.
A novel, at-home test was accurate and reliable in measuring near visual acuity and may be a helpful self-monitoring tool for patients with chronic ocular conditions or limited access to conventional examinations, according to a study.
“Remote patient monitoring, facilitated by home-based systems, holds the potential to enhance accessibility to health care services and improve patient outcomes across a wide range of ocular conditions, mainly in patients with chronic eye conditions or lack of access to office-based examinations,” Hadas Ben-Eli, PhD, director of optometry and biometry service at Hadassah Medical Center in Israel, and colleagues wrote in the Journal of Clinical Medicine. “Additionally, home monitoring can enhance the quality of care, leading to improved outcomes and reduced health care costs.”
In a cross-sectional study, researchers developed and validated a self-administered near visual acuity card test, the Hadassah Self-Visual Acuity Screener (HSVA), which they compared with the traditional Snellen chart and Rosenbaum Pocket Visual Screener (RPVS). They enrolled 275 participants aged 18 to 89 years (mean age, 42.5 years; 47% women) with a minimal best corrected visual acuity of 1 logMAR in at least one eye from ophthalmology and optometry clinics in Israel.
Researchers assessed the repeatability of the HSVA on 38 participants who underwent testing twice within a 1-week interval using the Snellen chart, RPVS and HSVA, while ophthalmic technicians used these three tests to measure BCVA on the remaining 237 participants. Of those, 67 individuals received verbal instructions and a video for self-testing with HSVA, the results of which were compared with a masked technician’s findings.
According to results, the test-retest reliability analysis yielded similar values for each test, with “very good correlations and repeatability” (P < .001). When comparing HSVA with the conventional tests, researchers reported that BCVA values between all three were similar (P = .10). Similarly, results of the self-test HSVA and that performed by the masked technician were comparable and demonstrated “very good agreement” (P < .001).
Further, multivariate analysis showed that HSVA could predict both RPVS and Snellen results with relatively high accuracy.
“In this study, a new card for the self-test monitoring of near VA was developed and validated. The HSVA incorporates decimal units, which are absent in standard near cards, as well as additional lines to assess high levels of VA, simple instructions and a video guide for self-testing,” Ben-Eli and colleagues wrote. “Moreover, this study evaluated the agreement of the card with an existing near test and the patient’s self-testing ability, and, therefore, it can be applied in clinical settings, but with caution, considering that it does not fully represent distance VA.”
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