Abstract
Purpose :
The purpose of this study was to develop a patient-centered at-home vision screening kit that could easily be used by a predominantly non-English speaking, underserved population with poor access to vision care. The need was initially created by the COVID-19 pandemic at a time when outpatient eye clinics were closed. The primary aim of this study was to determine whether visual acuity (VA) measurements conducted at home by patients with the self-test kit would have high correlation with that measured in clinic.
Methods :
A single institution, prospective, cross-sectional study was conducted by recruiting adult patients from an urban free clinic. After informed consent, we collected demographic information, near visual acuity and results of Amsler grid testing in each eye during in-person patient visits. Following enrollment, patients were contacted by telephone at home and results of the self-test kit were collected.
Results :
101 of 141 patients completed the study. Of those patients, 60.4% (n=61) were female. Mean age was 59.69 ± 14 years (mean ± SD). Of the 101 patients, 95% (n=96) were born outside of the United States, 81.2% (n=82) did not speak English as their primary language, 47.5% (n=48) were not enrolled in health insurance, 67.3% (n=68) expressed difficulty in accessing eye care, and 50.5% (n=51) reported that the COVID-19 pandemic worsened access. The mean annual household income was reported to be 8,091 ± 13,407 dollars. For the right eye (n=101), the mean in-person VA LogMAR was 0.303 ± 0.268 and mean at-home VA LogMAR was 0.297 ± 0.274 (p=0.681). For the left eye (n=101), the mean in-person VA LogMAR was 0.274 ± 0.253 and mean at-home VA LogMAR was 0.270 ± 0.248 (p=0.794). The correlation coefficient for the in-person and at-home VA LogMAR scores was r=0.880 [95% CI, 0.827 to 0.918] (p<0.0001) right eye and r=0.877 [95% CI, 0.823 to 0.916] (p<0.0001) left eye. The overall reproducibility rate of Amsler grid screening for in-person and at-home testing was 97.7% for each eye.
Conclusions :
The near visual acuity measurements tested in-clinic can be accurately reproduced in an at-home setting and with high correlation. The Amsler grid also showed highly reproducible results in both settings. These findings suggest that a simple at-home vision screening kit can be used successfully by an underserved population in which English is not the primary spoken language.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.