Evaluating The Efficacy Of A Mobile Phone Base Application For Self Assessment Of Visual Acuity For Singaporean Patients

Assessment of visual acuity(VA) is an essential component of the functional evaluation of patients
presenting to ophthalmologists. The information allows the clinician to assess if there is any visual
impairment as well as to monitor for visual deterioration in patients with eye conditions as well as
functional recovery after treatment.

A single center, prospective observational cohort study was conducted to evaluate the efficacy and
accuracy of a mobile phone base application (EySEE) for self assessment of visual acuity.

Instructions were given in the patient’s preferred language (English or Mandarin) on the use of mobile Eysee app via an educational video on how to navigate the app. A suitable mobile phone provided by the study team will be used to conduct the Eysee mobile VA test on patients. The clinical VA testing in LogMAR for distance and near was then done by a blinded evaluator. 

EySEE app demonstrated good agreement with clinical VA measurements, with 75.39% of assessments falling within 2 lines of clinical VA. Agreement rates were higher for patients with good VA (77.14% within 2 lines for VA better than 6/12) than those with moderate VA (72.72% within 2 lines) and poor VA (41.18% within 2 lines). Age emerged as a significant factor influencing agreement rates, with patients aged 70 years and younger achieving 84% agreement within 2 lines, which was further corroborated by multivariate analysis. In addition, root mean squared error (RMSE) analysis indicated that the app's repeatability was 0.145 within 2 lines, which is comparable to the variability observed in standard clinical VA measurements which was 0.151.

EySEE mobile app shows good agreement with clinical VA measurements. It offers a practical solution
for consistent, accurate home-based VA monitoring and reducing dependency on clinical visits,
thereby enhancing healthcare accessibility and efficiency, and improving patient flow