Comparison of visual acuity measured by ETDRS based smart phone applications I sight pro and Peek acuity versus traditional Snellen\'s chart visual acuity in children 6-14 years in a tertiary care institute in India

Covid-19 pandemic has led to children missing schools due to which eye care screening activities at schools have taken a backseat. To mitigate this home based visual acuity estimation smartphone applications are increasingly being used for the purpose of tele-ophthalmology purposes, although with no validation of the same. We aim to fulfil this lacunae. Current study was a cross sectional analysis on 286 eyes of 148 children aged between 6years to 14years attending our OPD from April 2021 to June 2021, with non-acute ocular symptomatology. Snellen’s distant visual acuity was compared against the visual acuity recorded by smart phone based Isight pro app and Peek acuity smart phone app. Statistical analysis was performed by Bland Altmann analysis by using SPSS version 21 and p<0.05 was taken as the level of significance. The mean differences between the smartphone-based test Isight pro and the Snellen’s chart and the smartphone-based test Peek acuity and Snellen’s acuity data were 0.06 (95%CI, 0.04–0.08) and 0.07 (95%CI,0.05–0.09) logMAR, respectively. Time taken to test visual acuity by Snellen’s chart was approximately 118.2±21.38 seconds, whereas with Isight pro and Peek acuity smart phone apps the time for testing was approximately 92±15.88 seconds and 94.03±19.73 seconds respectively. P<0.05. The mean visual acuity was comparable with Snellen’s chart and ETDRS based smart phone apps like Isight pro and Peek acuity. The mean time to assess visual acuity was slightly more in Snellen’s acuity than with smart phone based apps. Inability to access eye care services through screening activities in schools has been mitigated effectively by using these smart phone apps. Hence these smart phone apps can be effectively used in tele-ophthalmologic practice and screening activities in these COVID-19 pandemic times.