Real-world performance of a home based online eye test in a large healthy population 

Delivering eye care remains a global public health problem due to a lack of access to eye care services, particularly in less developed regions of the world. Poor eyesightedness due to lack of availability of an eye check and the prescription of correct glasses, is the leading cause of preventable visual impairment worldwide.

The answer to this stressed access to care, could be remote eye tests. Although a number of online eye tests are available, only a minority are clinically validated and certified as a Medical Device and focus on using medical research to continue to develop. 

We have previously reported on the validity of the ease web-based eye test in controlled settings (Wisse, R. P. L. et al., 2019, Muijzer, M. B. et al., 2021, Claessens, J. et al., 2023) . However, it is significant to also assess the external validity and accuracy of this novel technology in a real-world setting.

In a newly published paper, a staggering 14,680 eyes were analysed between 2021 and 2022. The participants were 18–45 years of age with refractive errors ranging between −3.50 to + 2.00S with up to −2.00 Diopter of astigmatism.

67% were within ±0.50 D and 82% were within  ±0.75 D. Given that, for adults and children, myopia is the predominant refractive error worldwide, it is exciting to see the potential for remote testing at home. In comparison, the test underestimated long-sightedness (34% and 50% within ±0.5D and ±0.75D), highlighting areas for future work.

Myopic and hyperopic signation is correctly reported in 96% and 44% of cases in the myopes and the hyperopes respectively. We can be excited about the easee eye test and its potential in increasing accessibility to care by delivering a valuable alternative for uncomplicated refractive error assessments.

References:
Wisse, R. P. L. et al. Validation of an Independent Web-Based Tool for Measuring Visual Acuity and Refractive Error (the Manifest versus Online Refractive Evaluation Trial): Prospective Open-Label Noninferiority Clinical Trial. J. Med. Internet Res. 21, e14808 (2019).

Muijzer, M. B. et al. The evaluation of a web-based tool for measuring the uncorrected visual acuity and refractive error in keratoconus eyes: A method comparison study. PLoS ONE 16, 1–13 (2021).

Claessens, J. et al. The Accuracy of a Web-Based Visual Acuity Selfassessment Tool Performed Independently by Eye Care Patients at Home: Method Comparison Study. JMIR Form. Res. 7, e41045 (2023).