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      Does the EyeChart App for iPhones Give Comparable Measurements to Traditional Visual Acuity Charts?

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          Abstract

          Aim:

          To investigate if the EyeChart app gives accurate visual acuity (VA) measurements that are comparable to those achieved using traditional VA charts.

          Method:

          Twenty-four participants (aged 18–27 years, mean 20.13 ± 1.78 years) with VA of 6/60 Snellen or better regardless of any strabismus, amblyopia, or ocular pathology volunteered for this prospective study. The best-corrected monocular VA of each participant’s right eye was measured on the Snellen chart at 6 m, the ETDRS chart at 3 m, and the EyeChart app presented on an iPhone SE at 1.2 m (4ft).

          Results:

          The mean VA scores obtained were: –0.13 ± 0.08 logMAR on the Snellen chart, –0.11 ± 0.08 logMAR on the ETDRS chart, and –0.09 ± 0.07 logMAR on the EyeChart app. After Bonferroni Correction adjustments were applied, a significant difference was found between the EyeChart app and the Snellen chart (t = –3.756, p = 0.003), however the difference between the EyeChart app and the ETDRS chart did not reach statistical significance (t = –2.391, p = 0.076). The EyeChart app had a strong correlation with both the Snellen (r = 0.79, p < 0.01) and ETDRS charts (r = 0.88, p < 0.01). The Coefficients of Agreement revealed a variation of less than one logMAR line between the EyeChart app and the traditional VA charts (Snellen: 0.09 logMAR; ETDRS: 0.08 logMAR).

          Conclusion:

          This study found that the EyeChart app gives accurate VA scores that are comparable to those achieved using the gold-standard ETDRS chart in a healthy young adult population. However, the accuracy and repeatability of the EyeChart app when testing a patient population must be investigated before it can be integrated into clinical practice.

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          Most cited references16

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          A Systematic Review of Healthcare Applications for Smartphones

          Background Advanced mobile communications and portable computation are now combined in handheld devices called “smartphones”, which are also capable of running third-party software. The number of smartphone users is growing rapidly, including among healthcare professionals. The purpose of this study was to classify smartphone-based healthcare technologies as discussed in academic literature according to their functionalities, and summarize articles in each category. Methods In April 2011, MEDLINE was searched to identify articles that discussed the design, development, evaluation, or use of smartphone-based software for healthcare professionals, medical or nursing students, or patients. A total of 55 articles discussing 83 applications were selected for this study from 2,894 articles initially obtained from the MEDLINE searches. Results A total of 83 applications were documented: 57 applications for healthcare professionals focusing on disease diagnosis (21), drug reference (6), medical calculators (8), literature search (6), clinical communication (3), Hospital Information System (HIS) client applications (4), medical training (2) and general healthcare applications (7); 11 applications for medical or nursing students focusing on medical education; and 15 applications for patients focusing on disease management with chronic illness (6), ENT-related (4), fall-related (3), and two other conditions (2). The disease diagnosis, drug reference, and medical calculator applications were reported as most useful by healthcare professionals and medical or nursing students. Conclusions Many medical applications for smartphones have been developed and widely used by health professionals and patients. The use of smartphones is getting more attention in healthcare day by day. Medical applications make smartphones useful tools in the practice of evidence-based medicine at the point of care, in addition to their use in mobile clinical communication. Also, smartphones can play a very important role in patient education, disease self-management, and remote monitoring of patients.
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            Visual acuity testing. From the laboratory to the clinic.

            The need for precision in visual acuity assessment for low vision research led to the design of the Bailey-Lovie letter chart. This paper describes the decisions behind the design principles used and how the logarithmic progression of sizes led to the development of the logMAR designation of visual acuity and the improved sensitivity gained from letter-by-letter scoring. While the principles have since been adopted by most major clinical research studies and for use in most low vision clinics, use of charts of this design and application of letter-by-letter scoring are also important for the accurate assessment of visual acuity in any clinical setting. We discuss the test protocols that should be applied to visual acuity testing and the use of other tests for assessing profound low vision when the limits of visual acuity measurement by letter charts are reached. Copyright © 2013 Elsevier Ltd. All rights reserved.
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              Standardizing the measurement of visual acuity for clinical research studies: Guidelines from the Eye Care Technology Forum.

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                Author and article information

                Contributors
                Journal
                Br Ir Orthopt J
                1743-9868
                The British and Irish Orthoptic Journal
                White Rose University Press
                1743-9868
                2516-3590
                15 April 2020
                2020
                : 16
                : 1
                : 19-24
                Affiliations
                [1 ]The University of Sheffield, GB
                Author notes
                Corresponding author: Katie Ansell ( kransell98@ 123456gmail.com )
                Article
                10.22599/bioj.146
                7510399
                3e37c4a8-1e7f-4c1d-aade-86dc64fd6a45
                Copyright: © 2020 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

                History
                : 17 January 2020
                : 19 March 2020
                Categories
                Research

                visual acuity,smartphone technology,eyechart app
                visual acuity, smartphone technology, eyechart app

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