Mobile apps, with proper validation, can accurately perform visual function tests
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Key takeaways:
- Mobile apps can successfully mimic paper-based visual function tests, results showed.
- Such apps may expand access to visual function testing.
- Peek Acuity was the most widely studied distance visual acuity app.
Mobile apps can accurately mimic paper-based visual function tests, allowing key visual metrics to be evaluated at home, but clinicians must validate an app before using it for clinical management, according to a study published in Eye.
Challenges of traditional paper-based visual function tests include that they are susceptible to degradation, require multiple versions and sometimes do not provide appropriate illumination, Thaiba Bano, with the School of Optometry in the College of Health and Life Sciences at Aston University in Birmingham, U.K., and colleagues wrote.
In comparison, mobile apps that test visual function provide appropriate illumination through a backlit screen, have multiple tests and versions readily available, and can allow patients to self-monitor acuity at home, according to Bano and colleagues.
To determine how these apps compare with conventional testing, the researchers searched PubMed and Web of Science for the key terms “visual function” and “app” to identify publications that validated these apps through 2023. They also reviewed relevant references cited in the papers.
The researchers identified 16 studies that assessed how such mobile apps measured distance visual acuity and seven studies that looked at how they measured near visual acuity. Peek Acuity (Peek Vision Ltd.) was the most widely studied distance visual acuity app.
Bano and colleagues found that the literature they reviewed indicated that mobile apps for visual acuity assessment generally perform well and can be used successfully by professionals and nonprofessionals in nonclinical settings. Visual acuity measurement apps can also scale letter size based on working distance and randomize the optotypes to prevent recall bias, conferring benefits paper-based tests cannot.
“The apps offer significant potential for the assessment and follow-up of patients receiving ophthalmic care and for children’s vision screening, especially in low-income countries,” Bano and colleagues wrote.
Similarly, mobile app tests for reading, contrast sensitivity, stereoacuity, color vision and visual field assessment accurately mimicked their corresponding paper-based tests, according to the researchers. However, it should be noted that some apps performed better or worse than others.
In some instances, the mobile apps performed better than the paper-based tests. For example, a digitization of the Radner chart on a tablet app had equivalent to better repeatability than the paper-based version of the reading test.
The researchers found that mobile apps can mimic most traditional paper-based visual function tests and can confer benefits unavailable to paper tests.
“However, this review only assessed those apps that have been evaluated in the scientific literature, which constitute just a small percentage of the total number of apps available for tablets and smartphones,” Bano and colleagues wrote.
“The consequences of incorrectly recorded visual function and using this to inform clinical management are serious, and, therefore, clinicians must check on the validity of a mobile app before adopting it as part of clinical practice,” they added.
Perspective
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In today’s world, digital screens of all sorts are ubiquitous in our lives. Evolving our health care landscape to properly incorporate this technology is a wise thing to do.
This article properly shows us practitioners, with its proper scientific backing, that not only can we begin incorporating digital/tablet-based versions of our various visual acuity testing, but that doing so actually improves access to visual health care in a manner that does not significantly affect cost for the patient or the practitioner.
It is the practitioner’s responsibility to know which apps are and are not reliable for a given acuity test, which is articulated well in this article. When reliable apps are used, actionable data can now be obtained from the patient and their caregiver/guardian from their own home without the need for more frequent office visits.
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