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. 2022 Apr;26(2):61.e1-61.e5.
doi: 10.1016/j.jaapos.2021.11.007. Epub 2021 Dec 15.

Web-based visual acuity testing for children

Eileen E Birch  1 , Lindsey A Hudgins  2 , Reed M Jost  2 , Christina S Cheng-Patel  2 , Sarah E Morale  2 , Krista R Kelly  3
Affiliations

Web-based visual acuity testing for children

Eileen E Birch et al. J AAPOS. 2022 Apr.

Abstract

Purpose: To evaluate a newly developed, web-based system for at-home pediatric visual acuity testing and to compare results with standard in-office visual acuity test results.

Methods: Children aged 3-12 years with and without visual deficits were enrolled (N = 65; 130 eyes). Monocular visual acuity was tested in-office using the ATS-HOTV (ages 3-6) or E-ETDRS (ages 7-12) protocol. Each child's family was emailed a link to a web-based version of the same visual acuity test for at-home testing. Equivalence was evaluated by using a linear mixed model to estimate the mean difference between in-office and at-home visual acuity test results and the corresponding two-sided 95% confidence interval.

Results: For children tested with the ATS-HOTV protocol, the mean difference between in-office and at-home visual acuity test results was 0.01 log MAR (95% CI, -0.06 to 0.09). For children tested with the E-ETDRS protocol, the mean difference was 0.04 log MAR (95% CI, -0.06 to 0.14).

Conclusions: At-home, web-based ATS-HOTV and E-ETDRS visual acuity test results had excellent concordance with in-office visual acuity testing. If the burden of travel is significant, at-home testing of children's visual acuity may provide the information needed to continue care when it might otherwise be discontinued or delayed.

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Figures

FIG 1.
FIG 1.
Bland-Altmann plot comparing ATS-HOTV visual acuity test results obtained in office and at home for 34 children (68 eyes) 3–6.9 years of age.
FIG 2.
FIG 2.
Bland-Altmann plot comparing E-ETDRS visual acuity test results obtained in office and at home for 31 children (62 eyes) 7–12 years of age.
See this image and copyright information in PMC

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