Visual Acuity Apps for Rapid Integration in Teleconsultation Services in all Resource Settings: A Review

Abstract

Purpose: There is a need for a simple and accurate way to assess visual acuity in telemedicine consultations in ophthalmology and other related specialties. Design: We surveyed visual acuity testing apps available that allow patients to measure their own acuity, focusing on freely accessible resources suitable for all resource settings. Methods: A systematic search was performed for visual acuity testing apps on 2 major platforms: Google Play Store (Google, CA, USA) and Apple App Store (Apple, CA, USA). Results: Sixteen apps (67%) tested near vision, 5 apps (21%) tested distance vision, and 3 apps (13%) offered options for both near and distance vision testing. Of the 24 apps, 5 (21%) offered a method of calibration of optotype size. Three apps (13%) demonstrated evidence of clinical validation. Only 3 apps fulfilled our criteria for suitability for clinical practice. Conclusions: We have recommended 3 apps that may be quickly integrated into clinical practice in both ophthalmic and non-ophthalmic all resource settings.

Novel web application for self-assessment of distance visual acuity to support remote consultation: a real-world validation study in children

“…Those available are difficult for the clinician to supervise remotely. [3][4][5][6][7] Paediatric ophthalmology clinics have high footfall, with many children requiring frequent reviews of VA for amblyopia therapy,…”

Analysis of the Reliability and Repeatability of Distance Visual Acuity Measurement with EyeSpy 20/20

“…Unlike other apps, EyeSpy 20/20 completely tests the full line (all 5 letters) at threshold and the full line (all 5 letters) below threshold to allow interpolation between lines, most apps, are not true LogMAR design, use Snellen or other less accepted optotypes, hence a better understanding of the pros and cons are important to understand. A systematic review of some of these apps have been reported elsewhere by Kawamoto et al) 13 and Claessens et al 14 …”

Virtual consultation for red eye

“…Free online mobile phone apps are available to check vision, but most of them have not gained regulatory approval 1718. In a prospective comparative study of app-based home vision testing in children, most families were able to generate results deemed useful for clinical decision making, but parental engagement was low 19…”