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    At-Home VA Testing Comparable to In-Office Version

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    Researchers at the Casey Eye Institute at Ore­gon Health and Science University (OHSU) in Portland have validated three at-home visual acuity (VA) tests. Their findings suggest that these home VA tests are comparable within 1 line to a standard in-office version.1

    Prompted by the pandemic. “Our collective experi­ences with telehealth during the COVID-19 pandemic highlighted the benefits and challenges of providing ophthalmology care through virtual visits,” said coau­thors Kellyn N. Bellsmith, MD, and Merina Thomas, MD.

    The unprecedented surge in demand for telehealth services heightened the need for reliable at-home VA tests. Hence, the OSHU team set out to evaluate the validity of three no-cost, at-home tests: a printed chart (University of Arizona/Banner Eye Health Chart), a mobile app (Verana Vision Test), and a website (www.Farsight.care).

    Study design. Eligible participants with VA of 20/200 or better were recruited from July 2020 to April 2021. Participants with internet or mobile device access were randomized to receive two of the three at-home tests to form the randomized cohort, while those without access were assigned to a mail-only cohort.

    At-home VA tests were completed within three days before a clinic visit, at which the best-corrected distance VA was measured as the reference standard.

    Results. A total of 121 participants (mean age, 63.8 years) completed the study. The mean in-office VA was 0.11 logMAR (Snellen equivalent 20/25). Mean differ­ence (logMAR) between the at-home test and in-office acuity was −0.07 (95% confidence interval [CI], −0.10 to −0.04) for the printed chart, −0.12 (95% CI, −0.15 to −0.09) for the mobile app, and −0.13 (95% CI, −0.16 to −0.10) for the website.

    Key finding. The analysis of the comparison data found all three at-home VA tests valid within 1 line of in-office results. “It was interesting that the printed chart had the smallest mean difference and greatest correlation compared with the in-office acuity mea­surement, although there was no statistically significant difference among the three tests,” Dr. Bellsmith said.

    A new normal? At-home VA testing provides import­ant data that can help providers with clinical decision making between in-person clinic visits, Dr. Bellsmith noted. And in looking to the future, Dr. Thomas said that ophthalmology “is very reliant on the physical exam, but the ability to have different care options will allow clinicians to provide care to a larger and more diverse population.”

    —Patricia Weiser, PharmD

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    1 Bellsmith KN et al. JAMA Ophthalmol. 2022;140(5):465-471.

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    Relevant financial disclosures: Drs. Bellsmith and Thomas: NIH: S; Research to Prevent Blindness: S.

    For full disclosures and the disclosure key, see below.

    Full Financial Disclosures

    Dr. Bellsmith NIH: S; Research to Prevent Blindness: S.

    Dr. Galor AstraZeneca: C; Dompé: C; Eye Cool: C; Novar­tis: C; Ocular Therapeutix: C; Tarsus: C.

    Dr. Scott Allergan: S; NEI: S; Regeneron: C,S.

    Dr. Thomas NIH: S; Research to Prevent Blindness: S.

    Dr. Yam None.

    Disclosure Category

    Code

    Description
    Consultant/Advisor C Consultant fee, paid advisory boards, or fees for attending a meeting.
    Employee E Hired to work for compensation or received a W2 from a company.
    Employee, executive role EE Hired to work in an executive role for compensation or received a W2 from a company.
    Owner of company EO Ownership or controlling interest in a company, other than stock.
    Independent contractor I Contracted work, including contracted research.
    Lecture fees/Speakers bureau L Lecture fees or honoraria, travel fees or reimbursements when speaking at the invitation of a commercial company.
    Patents/Royalty P Beneficiary of patents and/or royalties for intellectual property.
    Equity/Stock/Stock options holder, private corporation PS Equity ownership, stock and/or stock options in privately owned firms, excluding mutual funds.
    Grant support S Grant support or other financial support from all sources, including research support from government agencies (e.g., NIH), foundations, device manufacturers, and\or pharmaceutical companies. Research funding should be disclosed by the principal or named investigator even if your institution receives the grant and manages the funds.
    Stock options, public or private corporation SO Stock options in a public or private company.
    Equity/Stock holder, public corporation US Equity ownership or stock in publicly traded firms, excluding mutual funds (listed on the stock exchange).

     

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