While you aren’t likely to see many people in Nepal playing Candy Crush on an iPad®, you could see iPads® there in the not too distant future. But they won’t be used for entertainment: they’ll be used to screen for glaucoma.
This could be the result of a study presented at the American Academy of Ophthalmology AAO 2014 conference in Chicago. The study used iPads and a peripheral vision assessment app to screen 200 patients in Nepal for glaucoma. The findings showed promise for the potential of using iPads to screen populations at high risk of developing the disease, but with no access to traditional eye care.
Why would this be important? Glaucoma is the second leading cause of blindness across the globe, affecting over 60 million people. The degenerative eye disease can be effectively treated, if it is diagnosed early. However, glaucoma doesn’t exhibit symptoms in its early developmental stages, so patients are unaware they have it until it has progressed to where it affects vision. For those with access to regular health care, routine eye exams by an ophthalmologist or optometrist include glaucoma screenings and will detect the disease in its early stages. But in remote or underserved areas around the world, people don’t have access to such “normal” screenings, increasing their risk for glaucoma-related blindness.
So, researchers from the University of Iowa, the University of Maryland, Johns Hopkins University, the University of Michigan, and the Tilganga Eye Institute of Nepal teamed up to take iPads loaded with the peripheral vision app into a remote area of Nepal to see if such screening could be effective. They used the Visual Fields Easy app, which simulates a visual field test on an iPad and tested 400 eyes (200 patients).
For the control group, the team used 100 patients with healthy eyes. The other 100 had glaucoma. The researchers compared the iPad test to the traditional industry standard visual field test, known as the Humphrey SITA Standard 24-2. The two different tests agreed between 51-79 percent of the time. The highest level of agreement occurred in patients who had moderate and advanced visual field loss. There was less agreement in patients with mild visual field loss. There was a high false positive rate in the normal control group.
Despite the false positives, the researchers believe that conducting screenings using an iPad could 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 eye or health care.
“Visual field 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.”
Another aspect of the test was the time needed. The iPad screening took an average of 3 minutes, 18 seconds. Normal Humphrey SITA screenings need around seven minutes.
