Evaluation of Tablet-Based Tests of Visual Acuity and Contrast Sensitivity in Older Adults

Abstract

Purpose: Recent innovations in mobile technology for the measurement of vision present a valuable opportunity to measure visual function in non-clinical settings, such as in the home and in field-based surveys. This study evaluated agreement between a tablet-based measurement of distance and near acuity and contrast sensitivity as compared to gold-standard clinical tests.Methods: Participants aged ≥55 years recruited from a tertiary eye clinic underwent testing with three tablet-based and corresponding gold-standard clinical measures (ETDRS distance acuity, Pelli-Robson contrast sensitivity, and MNRead near acuity). Correlation and agreement between tablet-based and clinical tests were assessed.Results: A total of 82 participants with a mean age of 69.1 (SD = 7.6) years, and majority female (67.1%) and white (64.6%), were enrolled in this study. The mean (SD) difference between the tests (gold-standard - tablet) was -0.04 (0.08) logMAR for distance acuity, -0.11 (0.13) log units for contrast sensitivity, and -0.09 (0.12) logMAR for near acuity. 95% limits of agreement for distance acuity (-0.21, 0.12 logMAR), near acuity (-0.34, 0.14 logMAR), and contrast sensitivity (-0.36, 0.14 logCS) were also determined. The correlation between tablet-based and gold-standard tests was strongest for distance acuity (r = 0.78), followed by contrast sensitivity (r = 0.75), and near acuity (r = 0.67). The agreement between the standard and tablet-based methods did not appear to be dependent on the level of vision.Conclusions: This study demonstrates the agreement of tablet-based and gold-standard tests of visual function in older adults. These findings have important implications for future population vision health surveillance and research.

Keywords: Tablet-based vision tests; contrast sensitivity; distance visual acuity; iPad-based vision tests; near acuity.

Figures

Figure 1A.. Scatter Plot for Distance Visual Acuity

Note: Dashed line= fitted values; Solid line= true

Figure 1B.. Scatter Plot for Contrast Sensitivity

Note: Dashed line= fitted values; Solid line= true

Figure 1C.. Scatter Plot for Near Acuity

Note: Dashed line= fitted values; Solid line= true

Figure 2A.. Bland Altman Plot for Distance Visual Acuity

ETDRS= Early Treatment Diabetic Retinopathy Study Note: Dashed line= 95% limits of agreement; Solid line= mean

Figure 2B.. Bland Altman Plot for Contrast Sensitivity

Note: Dashed line= 95% limits of agreement; Solid line= mean

Figure 2C.. Bland Altman Plot for Near acuity

Note: Dashed line= 95% limits of agreement; Solid line= mean