Validation of selected iPhone optometric screening applications in vision screening.

Abstract

Introduction: There has been an unprecedent increase in the use of mobile technology to provide health care services. The eye care industry has also adopted the use of these innovative smart-technology devices to provide rapid, convenient and less time-consuming eye screenings through the use of applications (apps) however, the accuracy and reliability of these tests have not been fully established. Aim: To determine if the selected smartphone apps have comparable results to their equivalent standard clinical optometric tests. Method: The study employed a comparative research design that compared the results of two each, smartphone distance visual acuity (DVA), contrast sensitivity and astigmatism apps to the results provided by the standard Snellen DVA chart, Pelli-Robson chart and JCC test, respectively. A total of 113 participants were recruited using convenience sampling. The results were analyzed and the Wilcoxon Signed ranked test was used to assess for any comparisons. Results: The median DVA as determined by the Snellen test and both VA apps were found to be exactly the same (0.63) for both the right and left eyes. More participants passed the CS test with the smartphone apps as compared to the standard Pelli-Robson test. Statistically significant (p<0.001) lower percentages of participants were detected as having astigmatism by both smartphone apps when compared to standard clinical testing. Conclusion: The Kay iSight professional (paid) and Pocket Eye Exam (free) VA app testing, overall, showed promising results as they produced results similar to the standard Snellen test. Both the CS smartphone apps overestimated the results and both astigmatism apps significantly underestimated the number of participants with astigmatism. These apps therefore failed in providing accurate screenings results and need to be further modified before it can be used as a screening device. However, due to the lack of literature more studies need to be done before these devices can be used for home screenings or clinical use.