• Novel Device for Rapid Triage of Glaucoma Patients

    By Lynda Seminara
    Selected By: Prem S. Subramanian, MD, PhD

    Journal Highlights

    British Journal of Ophthalmology
    Published online Aug. 3, 2020

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    Jones et al. previously found that an eye-tracking device provided visual field (VF) data comparable to that of standard automated perimetry (SAP). They followed up on these initial results by investigating whether this open-source device, known as Eye­catcher, could identify patients with pronounced VF loss (mean deviation [MD] worse than –6 dB in at least one eye) and flag false-positive referrals (MD > –2 dB) in the waiting room of a busy glaucoma clinic. They found that Eyecatcher may be a quick and conve­nient complement to SAP.

    In this study, adults on a routine visit to a U.K. glaucoma clinic were instructed to sit 55 cm from a Win­dows Surface Pro 4 tablet and look at anything they saw on it. Targets of varying intensity were displayed, and a clip-on eye tracker determined which targets were noticed. The test was done twice in the same eye. Participants answered a five-item questionnaire about Eyecatcher and conventional SAP (performed later in the same visit).

    The 77 enrollees included returning patients with established glaucoma and new false-positive referrals (with no measurable VF loss or optic nerve abnormalities). Sixty-nine patients completed the study. Accuracy between Eyecatcher (mean hit rate) and SAP (MD) based on 11 new referrals and 11 randomly selected follow-up patients was consistent (Spearman correlation, r = 0.78; p < .001). Eyecatcher had good capability to distinguish MD less than –6 dB from MD greater than –2 dB (area under the receiver operating curve, 0.97). Moreover, Eyecatcher flagged 68% of false-positive referrals as functionally normal and labeled no patients with substantial VF loss as vi­sually normal. However, some patients with a healthy VF scored poorly. Eye­catcher was faster than SAP, and par­ticipants considered it more enjoyable and easier to perform (both p < .001). SAP had better test-retest reliability and tested more locations.

    Eyecatcher shows potential to priori­tize patients at busy clinics and could prevent unnecessary patient visits if used in a comprehensive ophthalmolo­gy setting. It also may be ideal for home monitoring and for people with limited physical or cognitive ability, the authors said. They cautioned that the device cannot test central vision and, without improvements, would be a poor general screening tool if both high sensitivity and high specificity are required.

    The original article can be found here.