The validity of spectacle prescriptions via tele-optometric comprehensive eye examinations; a pilot study

Abstract

Purpose : Currently, there are no laws that outline the role of tele-optometry in the state of Illinois. This pilot study may assist law makers in determining the usefulness of tele-optometry to underserved communities in urban and rural Illinois. This study aims to evaluate if the spectacle prescription that is determined in a tele-optometric setting is within the interobserver variability standards.

Methods : A cohort of 30 optometry students were recruited to participate in the study, excluding those with active ocular disease or recent ocular surgery. A tele-optometric comprehensive eye exam was completed by an in-person technician via DigitalOptometrics™ platform and videoconferencing with an investigator optometrist. This was then followed by the Gold standard in-person comprehensive eye exam by one of our investigator optometrists. Two masked clinicians independently reviewed and compared the exam findings between the tele-optometric exam and the in-person exam to determine if the spectacle prescriptions were valid. Parameters were set to ensure prescriptions were equivalent; spherical component +/- 0.50, cylindrical component +/- 0.50 and axis component +/- 015 degrees. Paired samples t-test and Wilcoxon signed rank test were used for statistical analysis.

Results : No statistically significant difference was found between the spherical, cylindrical, and axis components of the prescriptions found in the tele-optometric exam compared to the in-person exam given p > 0.05. Based on the criteria above, 27/30 (90.0%) of spectacle prescriptions were equivalent between the two exams. Of the 3 prescriptions which were not equivalent, 2 cases were low hyperopes that were given a low myopic prescription in the tele-optometric exam and the third case was a high myope that was slightly given extra minus in the tele-optometric exam.

Conclusions : Our data suggests that spectacle prescriptions were equivalent between tele-optometric and the Gold standard in-person comprehensive eye exams. Careful binocular balance should be employed to ensure patients are not over-minused. With ongoing advances in tele-optometry, these models may provide earlier intervention for corrective lenses in rural and underserved communities.

This is a 2020 ARVO Annual Meeting abstract.

 

Mean difference in prescriptions between tele-optometric and in-person exams

 

Comparison of refractive components between tele-optometric and in-person exam