Compared Near-Vision Testing With the Nintendo 3DS PDI Check Game on the Thai-Burma Border

Samuel J Martin, Kayla S Rowe, Nay Hser, Hser Eh Htoo, Ray Khin, Kyle A Smith, Robert W Arnold, Samuel J Martin, Kayla S Rowe, Nay Hser, Hser Eh Htoo, Ray Khin, Kyle A Smith, Robert W Arnold

Abstract

Background: A near vision game has been developed for the autostereoscopic screen of the Nintendo 3DS console. Ease of use and time for testing by non-English-speaking patients was not known.

Methods: Adult and pediatric patients in a remote Burma clinic were compared with US military staff with each performing conventional near acuity, Stereo Fly, and Ishihara color in addition to PDI Check game, so results could be correlated and timed.

Results: Seventeen Burma adults (aged 19-58), 20 Burma children (aged 7-15), and 14 US military staff (aged 21-36) completed the testing. Conventional testing correlated with PDI Check for stereo (P < 0.001), acuity oculo dexter (P < 0.01), acuity oculo sinister (P < 0.01). For visual acuity and stereopsis, the intraclass coefficient was 0.55 [95% confidence interval (CI) 0.28-0.72] and 0.62 (95% CI 0.41-0.77) respectively, but with few color deficient cases color was 0.30 (95% CI -0.05 to 0.60). The time in seconds to complete near vision testing with PDI Check (172 ± 27, overall; 198 ± 34, Burma; 99 ± 20, military) was significantly (25% ± 18%) briefer than conventional testing (226 ± 31, overall; 270 ± 34, Burma; 126 ± 20, military). The Burma patients took significantly longer than the military staff (234 ± 25 vs 112 ± 14, P < 0.01). Time for Burma children did not differ from Burma adults for PDI (109 ± 47 vs 217 ± 54, P = 0.42) and for conventional testing (266 ± 51 vs 275 ± 52, P = 0.80).

Conclusions: Non-English-speaking Burma children and adults were able to reliably perform 3 types of near vision testing with a Nintendo 3DS game 25% quicker than the 2 to 3 minutes for conventional methods. They were slower than experienced US military staff adults.

Figures

FIGURE 1
FIGURE 1
PDI Check near vision game on the Nintendo 3DS employed by Jungle School of Medicine Kawthoolei medics at the Cross Border Clinic near the Thai-Burma border.
FIGURE 2
FIGURE 2
Bland-Altman Plot for Visual acuity comparing Nintendo 3DS PDI Check game with conventional testing with Rosenbaum near card at 35 cm. The PDI Check version 0.1.7 underestimates decimal acuity by 0.15.
FIGURE 3
FIGURE 3
Bland-Altman Plot for stereopsis comparing PDI Check game with Titmus Fly stereo. The PDI Check formula in version 0.1.7 overestimates stereo by about 80 arc seconds.

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Source: PubMed

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