JMIR Publications

ABSTRACT

Background:

Telehealth solutions can play an important role in increasing access to eye care. A web-based tool for self-assessing visual acuity (VA) has previously been studied in controlled, supervised conditions. The accuracy of this tool when performed independently by patients in their home environment, using their own devices, has not yet been examined.

Objective:

To examine the accuracy of a web-based tool with respect to measuring VA in ophthalmic patients in their home environment, compared to a conventional in-hospital assessment using a Snellen chart (the gold standard).

Methods:

From April 2020 through September 2020, consecutive adult uveitis patients at the University Medical Center Utrecht, the Netherlands, were invited to use the remote web-based VA test at home (the index test) within two weeks of their upcoming conventional VA assessment at the hospital (the reference test).

Results:

A total of 98 eyes in 59 patients were included in the study. The difference in VA between the index and reference tests was not significant, with a mean (±SD) difference of 0.02±0.12 logMAR (95% limits of agreement: -0.21 to 0.26 logMAR; P=0.09). The majority of the differences (77%) fell within the pre-determined acceptable deviation limit of 0.15 logMAR. In addition, no patient characteristics or clinical parameters were found to significantly affect the accuracy of the web-based tool.

Conclusions:

This web-based test for measuring VA is a valid tool for remotely assessing VA, also when performed independently by patients at home. This is particularly relevant when the patient’s access to ophthalmic care is limited. Future iterations should focus on reducing environmental and behavioral effects to limit outliers. Implementation of this web-based tool in the healthcare system may represent a valuable step forward in revolutionizing teleconsultations and can provide individual patients with the opportunity to self-monitor changes in VA.