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
• iPad-based vision tests
• near acuity
• distance visual acuity
• contrast sensitivity

Commercial relationships disclosures

Ridgevue Vision provided the iBook used in this study free of charge but had no role in the design or conduct of this study or the decision to publish its findings. JRE has worked with Ridgevue Vision on other projects but has not received any compensation from Ridgevue Vision at any time.

Additional information

Funding

This work was supported by the National Institutes of Health under grant [K23EY027848] (to JRE) and grant [K01AG052640] (to BKS).