Background/Objectives Ophthalmic disorders cause 8% of hospital clinic attendances, the highest of any specialty. The fundamental need for a distance visual acuity (VA) measurement constrains remote consultation. A web-application, DigiVis, facilitates self-assessment of VA using two internet-connected devices. This prospective validation study aimed to establish its accuracy, reliability, usability and acceptability. Subjects/Methods In total, 120 patients aged 5–87 years (median = 27) self-tested their vision twice using DigiVis in addition to their standard clinical assessment. Eyes with VA worse than +0.80 logMAR were excluded. Accuracy and test-retest (TRT) variability were compared using Bland–Altman analysis and intraclass correlation coefficients (ICC). Patient feedback was analysed. Results Bias between VA tests was insignificant at −0.001 (95% CI −0.017 to 0.015) logMAR. The upper limit of agreement (LOA) was 0.173 (95% CI 0.146 to 0.201) and the lower LOA −0.175 (95% CI −0.202 to −0.147) logMAR. The ICC was 0.818 (95% CI 0.748 to 0.869). DigiVis TRT mean bias was similarly insignificant, at 0.001 (95% CI −0.011 to 0.013) logMAR, the upper LOA was 0.124 (95% CI 0.103 to 0.144) and the lower LOA −0.121 (95% CI −0.142 to −0.101) logMAR. The ICC was 0.922 (95% CI 0.887 to 0.946). 95% of subjects were willing to use DigiVis to monitor vision at home. Conclusions Self-tested distance VA using DigiVis is accurate, reliable and well accepted by patients. The app has potential to facilitate home monitoring, triage and remote consultation but widescale implementation will require integration with NHS databases and secure patient data storage.

PurposeAutosomal dominant optic atrophy (ADOA) associated with OPA1 variants is the most common inherited optic neuropathy in the population. The utility of the Ganzfeld electroretinogram (ERG) in evaluating ADOA has not been extensively investigated. In this study, we explored the potential of using a handheld ERG device (RETeval®) to measure ERG responses in a cohort of patients with ADOA carrying pathogenic OPA1 mutations.MethodsThe Ganzfeld photopic ERG was recorded in 15 individuals with OPA1‐associated ADOA in response to series of flashes (200, automatically adjusted in intensity to pupil diameter) using the RETeval® handheld ERG device and skin electrodes. Two to three series were obtained from each eye. The recordings were analysed for noise and drift manually. Both visual acuity measurements, and optical coherence tomography ganglion cell layer (GCL) and retina nerve fibre layer (RNFL) thicknesses were recorded to explore correlation with ERG parameters.ResultsThere was a significant correlation between LogMAR visual acuity and both the a‐wave (ρ = ‐0.60, p = 0.02, n = 15) and b‐wave (ρ = ‐0.54, p = 0.04, n = 15) peak times. As a‐wave and b‐wave peak time correlated with age, a multiple linear regression analysis was performed to exclude age as a confounder. With respect to the a‐wave analysis, the coefficients for visual acuity and age were ‐0.66 (p = 0.019) and 0.015 (p = 0.14), respectively. With respect to b‐wave analysis, the coefficients for visual acuity and age were ‐1.32 (p = 0.017) and 0.028 (p = 0.16), respectively. There was no significant correlation between a‐wave and b‐wave peak times with the OCT structural parameters that were analysed.ConclusionsIn patients with OPA1‐associated ADOA, a‐wave and b‐wave peak times correlated negatively with LogMAR visual acuity, independent of the effects of age. The pathophysiological relevance of these findings requires further investigation in a larger patient cohort.