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. 2021 Apr 9;17(1):70-78.
doi: 10.22599/bioj.172. eCollection 2021.

Evaluation of a New Method to Track Changes in Vision at Home for Children Undergoing Amblyopia Treatment

Anna O'Connor  1 , Martha Waters  2 , Laura England  2 , Ashli Milling  1 , Hazel Kay  3
Affiliations

Evaluation of a New Method to Track Changes in Vision at Home for Children Undergoing Amblyopia Treatment

Anna O'Connor et al. Br Ir Orthopt J. .

Abstract

Purpose: A new amblyopia tracker app has been designed to provide parents with a method of monitoring a child's vision by presenting a single optotype size that the tester moves to identify the furthest distance the optotypes can be seen. The aim of this study is to evaluate this methodology in adults, comparing the findings to visual acuity (VA) measured with the iSight app and to determine the test retest variability.

Methods: Adults, aged 18-39 years, with no known eye condition and VA ≤ 0.7 logMAR were recruited. Bangerter filters were used to simulate amblyopia, where VA was reduced below 0.0 with an interocular difference of at least 0.2 logMAR. Testing for both apps was performed monocularly, with the test order being randomised.

Results: Data from 32 subjects were analysed. For the test retest variability analysis, paired t-tests showed no statistically significant difference between the tests for either eye, either app or the interocular acuity difference (p > 0.3 in all cases). Bland Altman plots showed similar limits of agreement between the two apps. When comparing measurements between the apps there was no statistically significant difference on the first or second test, either eye or the interocular acuity difference (p > 0.5 in all cases).

Conclusion: The results support the theory that changing distance is a valid method of assessing VA as the measurements agree well with the standard approach of reducing optotype size. Test retest variability is similar between the two apps and there is good agreement between the measurements.

Keywords: amblyopia; app; optotype; test retest variability; visual acuity.

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Conflict of interest statement

HK is a director of Kay Pictures Ltd, which developed the Amblyopia Tracker app. The app was funded by a UK Government Covid Innovation grant award and the research has been funded by Kay Pictures Ltd. A UK patent pending No. 2019264.7 has been filed. The other authors have no competing interests.

Figures

Figure 1
Figure 1
Bland Altman showing agreement between test one and test two of the right eye for the tracker app, comparing the mean of the two tests against the difference.
Figure 2
Figure 2
Bar chart showing the numbers of participants and the difference in VA between test one and two for each eye and each test.
Figure 3
Figure 3
Bland Altman plot of the right eye data comparing responses between the two test methods.
See this image and copyright information in PMC

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