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iPad screenings effective for detecting early signs of glaucoma in underserved, high-risk populations
Using a tablet
screening app could prove to be an effective method to aid in the effort to
reduce the incidence of avoidable blindness in populations at high-risk for
glaucoma with limited access to health care, according to a study released
today at AAO 2014, the 118th annual meeting of the American Academy of
Ophthalmology. In this study, researchers from the University of Iowa, the
University of Maryland, Johns Hopkins University, the University of Michigan
and the Tilganga Eye Institute in Nepal used a free peripheral vision
assessment app to screen approximately 200 patients in Nepal for glaucoma using
an iPad®. The results show promise for screening populations that have limited
or no access to traditional eye care and certain ethnic groups that have a high
risk of developing the disease.
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Glaucoma is the second
leading cause of blindness worldwide, affecting more than 60.5 million
people. The disease can be effectively treated; however, it generally does
not present symptoms in its early stages, resulting in many patients being
unaware that they suffer from the condition until it progresses to later
stages. Early diagnosis can easily be achieved through a routine examination
from an ophthalmologist -- a medical doctor specializing in the diagnosis,
medical and surgical treatment of eye diseases and conditions -- or an
optometrist. While it is relatively easy for patients with access to regular
health care in developed nations to be screened for glaucoma during a routine
eye examination, remote and underserved communities have limited or no access
to such services, increasing their risk for glaucoma-related blindness.
In order to determine
if a screening test using mobile technology could be effectively administered
to communities outside of a traditional clinical setting, the research team
used the Visual Fields Easy app, which simulates a visual field test on an iPad
(1st Generation), to screen more than 400 eyes for glaucoma.
Approximately half of
the eyes screened were healthy "control" eyes and the other half were
eyes with glaucoma. The researchers compared the screening results to those
from the traditional industry standard visual field test, known as the Humphrey
SITA Standard 24-2, and found that the two tests agreed between 51-79 percent
of the time.
The best agreement was
in patients with moderate and advanced visual field loss, while there was less
agreement in patients with mild visual field loss. The researchers believe this
was due to a high false positive rate for normal controls. While the agreement
rate and cost-benefit ratio of the results were not strong enough to support
using the method for screening general populations, the researchers believe
that conducting screenings using a tablet can be an effective initial screening
tool for high-risk groups, such as people of African or Hispanic ancestry, the
elderly and people with limited or no access to traditional eye and health
care. In addition, the screenings lasted an average of 3 minutes and 18 seconds
-- less than half the average time needed for the Humphrey SITA Standard test.
testing equipment is neither portable nor affordable to some populations around
the world, limiting entire regions from accessing health and eye care,"
said lead researcher Chris A. Johnson, Ph.D., director of the Visual Field
Reading Center at the University of Iowa. "Although not perfect, the
tablet glaucoma screening method could make a significant difference in remote
locations where populations would not otherwise receive screening at all."
The above story is based on materials provided by American Academy of Ophthalmology (AAO).
Note: Materials may be edited for content and length.
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