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Kaccie Y Li, Huy Tran, David Shu; Wavefront-based autorefraction on a telemedicine platform. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1137.
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© ARVO (1962-2015); The Authors (2016-present)
SVOne Enterprise by Smart Vision Labs (SVL) integrates wavefront sensing on a smartphone with a proprietary telemedicine platform. Refractive-error measurements along with other clinically relevant data are collected and transmitted for an ophthalmologist to remotely review and generate a prescription (Rx). In this study, we evaluate the agreement between SVOne-produced autorefraction (AR) results and the final doctor’s Rx.
Fifty-four healthy eyes, 27 individuals (ages 18 to 60), went through an SVOne Enterprise in a retail setting. Fourteen individuals provided glasses which were measured and entered into the platform (lensometer data). Image-processing algorithms built into the SVL iOS app automatically recognizes, captures and analyzes 3 Shack-Hartmann spot images to produce each AR result. Furthermore, every individual goes through a standard ocular health questionnaire and visual acuity test both of which are conducted through the app. All results along with Shack-Hartmann images and technician comments on patient satisfaction of current glasses (if available) are transmitted through SVL’s HIPAA-compliant platform to a panel of ophthalmologists for review. An ophthalmologist-prescribed Rx is emailed within 24 hours.
Final Rx ranged from -8.00 D to 3.00 D and -1.50 D to 0.00 D for SPH and CYL respectively. Across the board results for AR and Rx differed on average by 0.40 D. Agreement improves to 0.23 D when lensometer data was not available to the ophthalmologists. Comparison of cylindrical correction (CYL and AXIS) for the lensometer group was not made due to doctors often prescribing directly off the lensometer. When lensometer data is not available, CYL differed by an average of 0.35 D while Rx AXIS was generally taken directly from AR. No CYL was prescribed for 3 eyes with AR-measured CYL of -0.25 D; it was also ignored for 2 eyes with greater levels of CYL (-0.75 D and -1.00 D).
A telemedicine platform built on wavefront-sensing technology was developed for providing eyeglass prescriptions in a retail setting. Agreement between AR and Rx for SPH is excellent. Prescribing habits using lensometer data for cylindrical correction varied greatly across different ophthalmologists not allowing for a meaningful comparison between AR and Rx. However when lensometer data was not available, agreement between AR and Rx for CYL and AXIS is good.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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