Pinhole does not increase screening accuracy of detecting decreased best corrected visual acuity in schoolchildren

Background Decreased best corrected visual acuity among children should be treated early in life, and vision screening in schoolchildren is an efficient and feasible selection for developing countries. Thus, the screening accuracy of different visual acuity tests is the key point for making vision screening strategies. The present study aims to explore the screening accuracy of uncorrected visual acuity (UCVA) and pin-hole corrected visual acuity (PCVA) using different vision chart in the detection of decreased best-corrected visual acuity (BCVA) among schoolchildren. Methods Grade one primary schoolchildren in urban Lhasa with data of UCVA using tumbling E chart (UCVAE), PCVA using tumbling E chart (PCVAE), UCVA using Lea Symbols chart (UCVAL), PCVA using Lea Symbols chart (PCVAL) and BCVA using Lea Symbols chart were reviewed. Decreased BCVA was defined as BCVA≤20/32(≥0.2 logMAR). Difference, reliability, and diagnostic parameters in the detection of decreased BCVA of different visual acuity results were analyzed. Results Overall, 1672 children aged 6.58 ± 0.44 years fulfilling the criteria. The prevalence of decreased BCVA was 6.8%. Although no significant differences were found between UCVAE vs UCVAL (p = .84, paired t-test) as well as PCVAE vs PCVAL (p = .24), the ICC between them was low (0.68 and 0.57, respectively). The average difference between BCVA and UCVAE, UCVAL, PCVAE, PCVAL was logMAR -0.08 (− 0.37, 0.21), − 0.08 (− 0.29, 0.17), − 0.05 (− 0.30, 0.19), − 0.06 (− 0.23, 0.12) using Bland–Altman method. The area under the receiver operating characteristic curve of UCVAE, PCVAE, UCVAL, PCVAL for the detection of decreased BCVA was 0.78 (0.73, 0.84), 0.76 (0.71, 0.82), 0.95 (0.94, 0.96), 0.93 (0.91, 0.95), respectively. Conclusion Pinhole does not increase the screening accuracy of detecting decreased BCVA in grade one primary schoolchildren. Visual acuity test using Lea Symbols is more efficient than Tumbling E in the screening of that age. Trial registration Data were maily from the Lhasa Childhood Eye Study which has finished the clinical registration on (ChiCTR1900026693).

Applications of dynamic visual acuity test in clinical ophthalmology

Dynamic visual acuity test (DVAT) plays a key role in the assessment of vestibular function, the visual function of athletes, as well as various ocular diseases. As the visual pathways conducting dynamic and static signals are different, DVATs may have potential advantages over the traditional visual acuity tests commonly used, such as static visual acuity, contrast sensitivity, and static perimetry. Here, we provide a review of commonly applied DVATs and their several uses in clinical ophthalmology. These data indicate that the DVAT has its unique clinical significance in the evaluation of several ocular disorders.

The evaluation of a novel tool to remotely assess visual acuity in chronic uveitis patients during the COVID-19 pandemic

BackgroundRestrictions due to the recent COVID-19 pandemic catalysed the deployment of telehealth solutions. A novel web‐based visual acuity test, validated in a healthy population, may be of great value in the follow‐up of uveitis patients.ObjectiveTo determine the measurement accuracy of the unsupervised remote Easee web‐based visual acuity test in uveitis patients, when compared to a conventional in‐hospital assessment.MethodsCross‐sectional diagnostic accuracy study. Between April 2020 and September 2020, consecutive adult uveitis patients were invited for the web‐based visual acuity test (index test) within two weeks prior to their conventional in‐hospital assessment (reference test).ResultsA total of 269 patients were invited by mail, of whom 84 visited the website (31%). Ultimately 98 eyes met the criteria for statistical analysis. The mean difference between the two tests was low and non‐significant: 0.02 logMAR (SD 0.12, P = 0.085). The 95% limits of agreement ranged from ‐0.21 to 0.26 logMAR. No relevant differences were identified in clinical characteristics between subgroups with a good performance (i.e. difference between the tests 0.15 logMAR) or underperformance (i.e. difference >0.15 logMAR) on the web‐based test.ConclusionThe web‐based visual acuity test is a promising tool to remotely assess visual acuity in the majority of uveitis patients, especially relevant when access to ophthalmic care is limited. No association between patient‐ or uveitis‐related variables and (under)performance of the test were identified. These outcomes underline the potential of remote vision testing in other common ophthalmic conditions. A proper implementation of this web‐based tool in health care could be of great value for revolutionizing teleconsultations.