Comparing a Home Vision Self-Assessment Test to Office-Based Snellen Visual Acuity

PURPOSE: To evaluate the agreement of a home vision screening test compared to standard in-office technician-measured Snellen visual acuity to allow for remote screening and triaging of patients. PATIENTS AND METHODS: In this prospective study, English-speaking patients with in-office ophthalmology appointments from May to August 2020 and visual acuity better than 20/125 were asked to complete a home vision test one week before their scheduled in-office appointment. The home vision test was a modified ETDRS chart displayed in a PDF document that could be printed or viewed on a monitor. The primary outcome was the mean difference between office-based and home visual acuity. RESULTS: Eighty-two eyes of 45 patients were included in the study with 45 study eyes analyzed. The mean difference between office-based and home visual acuity was −0.02 logMAR (SD 0.15, P=0.28) among study eyes. Of these eyes, 91% demonstrated agreement between the two methods within 0.2 logMAR of the mean difference, and 60% had agreement within 0.1 logMAR of the mean difference. There were no significant demographic or ocular risk factors leading to a greater difference between the tests. CONCLUSION: There was good agreement between the home and in-office Snellen tests for patients with vision better than 20/125. The home vision test can be used to remotely determine if there is a significant vision change of >0.2 logMAR or approximately 2 lines of visual acuity.