Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 7, 2023
Open Peer Review Period: Dec 7, 2023 - Feb 1, 2024
Date Accepted: Feb 29, 2024
(closed for review but you can still tweet)
Utilizing Smartphones to Enhance Vision screening in rural areas: a pilot study
ABSTRACT
Background:
While it is treatable, uncorrected refractive error is the top one leading cause of visual impairment globally. This eye condition alone, or together with ocular misalignment can also cause amblyopia, which is also treatable if detected early, but still occurs in about 4% of the population. Mass vision screening is the first and critical step to address those issues, but due to limited resource vision screening in many rural areas remains a big challenge.
Objective:
To pilot test the feasibility of using smartphone apps for vision screening in areas where access to eye care is limited.
Methods:
A vision screening was piggyback to a charity summer camp program in a rural county, Sichuan, China. Seventy-three 4th and 5th graders were tested for visual acuity using standard eye chart, for refractive error as well as heterophoria using two smartphone apps respectively, by non-professional personnel.
Results:
Five out of 73 (6.8%, 95% confidence interval, 2.3%-15.3%) students were found to have visual acuity worse than 20/20 (logMAR 0) in at least one eye. Among the five students, three primarily had refractive error. The other two students with manifest strabismus (one 72PD eso- and one 33PD exo-tropia), according to the photo screening app. Students without manifest strabismus were measured for phoria using the app in cover/uncover mode. The median [Interquartile range] of phoria was 0.0 [2.9PD eso to 2.2PD exo].
Conclusions:
The results from this vision screening study are consistent with findings from other population-based vision screening, in which conventional tools were used by ophthalmic professionals. The smartphone apps have potential to be used in mass vision screenings, to provide quantitative refractive error and ocular alignment tests, which are important for identifying risk factors for amblyopia, and for myopia control. The smartphone apps may bear significant implications for the future of low-cost vision care, particularly in resource-constrained and geographically remote areas.
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