The coronavirus disease 2019 pandemic has led to widespread change as public health strategies for containment have emphasized social distancing and remaining at home. These policies have led to downscaled clinic volumes, cancellation of elective procedures, enhanced personal protective strategies in the clinic, and adoption of telemedicine encounters. We describe the evidence-based practical approach taken in our ophthalmology department to continue delivering eye care during the pandemic by rescheduling visits, enhancing clinic safety, and adopting virtual video encounters.

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Ophthalmology Practice During the Coronavirus Disease 2019 Pandemic: The University of Pittsburgh Experience in Promoting Clinic Safety and Embracing Video Visits.

The progressive deterioration of the visual function in patients on waiting lists for cataract surgery has a negative impact on their quality of life, especially in the elderly population. Patient waiting times for cataract surgeries in many healthcare settings have increased recently due to the prolonged stop or slowdown of elective cataract surgery as a result of coronavirus disease 19 (COVID-19). The aim of this review is to highlight the impact of such a "de-prioritization" of cataract surgery and to summarize some critical issues and useful hints on how to reorganize cataract pathways, with a special focus on perioperative diagnostic tools during the recovery phase and beyond. The experiences of a group of surgeons originating from nine different countries, named the European COVID-19 Cataract Group (EUROCOVCAT), have been combined with the literature and recommendations from scientific ophthalmic societies and healthcare institutions. Key considerations for elective cataract surgery should include the reduction of the number of unnecessary visits and examinations, adoption of precautionary measures, and implementation of telemedicine instruments. New strategies should be adopted to provide an adequate level of assistance and to guarantee safety conditions. Flexibility will be the watchword and regular updates would be necessary following scientific insights and the development of the pandemic.

Rethinking Elective Cataract Surgery Diagnostics, Assessments, and Tools after the COVID-19 Pandemic Experience and Beyond: Insights from the EUROCOVCAT Group.

Purpose: To validate the Rosenbaum near vision card (Near Chart) and a smartphone-based visual acuity (VA) test (Eye Chart) against a standard retro-illuminated Early Treatment Diabetic Retinopathy Study (ETDRS) chart within participants Materials and Methods: A cross-sectional study of participants aged >=18 years was conducted VA was measured in all participants using the ETDRS chart, Near Chart and smartphone-based Eye Chart application, respectively VA was converted to logarithm of the minimum angle of resolution (logMAR) for statistical analysis Eyes with ETDRS VA worse than 1 0 logMAR (20/200) were excluded The main outcome measures were levels of agreement between VA measured using the Near Chart or Eye Chart application vs the ETDRS chart Results: A total of 295 eyes of 151 participants were included One hundred participants (66 2%) were female and the mean age was 64 3 +/- 12 5 years Educational level was high school or below for 49% of participants and at Bachelor's degree or above for 51% The median logMAR VAs of all eyes tested using the ETDRS chart, Near Chart and Eye Chart application were 0 1, 0 0 and 0 1, respectively The median VA difference between the Near Chart vs ETDRS chart and Eye Chart application vs ETDRS chart was 0 0 logMAR in both cases for both the right eye (OD) and left eye (OS) Intraclass correlation coefficient (ICC) demonstrated a strong positive correlation between VA tested with the Near Chart vs ETDRS chart (OD: ICC=0 85;p<0 001, OS: ICC=0 77;p<0 001) and Eye Chart application vs ETDRS chart (OD: ICC=0 88;p<0 001, OS: ICC=0 74;p<0 001) Conclusion: VA measurements with the Near Chart and smartphone-based Eye Chart application corresponded well to the standard ETDRS chart, suggesting potential utility of alternative portable VA tests for in-office or remote vision monitoring, particularly during periods of physical distancing such as the Coronavirus disease 2019 (COVID-19) era

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Comparison of Visual Acuity Measurement Using Three Methods: Standard ETDRS Chart, Near Chart and a Smartphone-Based Eye Chart Application

Historically, visual acuity has been the benchmark for visual function. It is used to measure therapeutic outcomes for vision-related services, products and interventions. Quantitative measurement of suboptimal visual acuity can potentially be corrected optically with proper refraction in some cases, but in many cases of reduced vision there is something else more serious that can potentially impact other aspects of visual function such as contrast sensitivity, color discrimination, peripheral field of view and higher-order visual processing. The measurement of visual acuity typically requires stimuli subject to some degree of standardization or calibration and has thus often been limited to clinical settings. However, we are spending increasing amounts of time interacting with devices that present high-resolution, full color images and video (hereafter, digital media) and can record our responses. Most of these devices can be used to measure visual acuity and other aspects of visual function, not just with targeted testing experiences but from typical device interactions. There is growing evidence that prolonged exposure to digital media can lead to various vision-related issues (eg, computer vision syndrome, dry eye, etc.). Our regular, daily interactions (digital behavior) can also be used to assess our visual function, passively and continuously. This allows us to expand vision health assessment beyond the clinic, to collect vision-related data in the whole range of settings for typical digital behavior from practically any population(s) of interest and to further explore just how our increasingly virtual interactions are affecting our vision. We present a tool that can be easily integrated into digital media to provide insights into our digital behavior.

https://www.dovepress.com/getfile.php?fileID=46832

Visual function, digital behavior and the vision performance index.

IntroductionVisual acuity (VA) testing is a vital screening tool for the assessment of ocular function. The coronavirus 2019 pandemic has caused an immediate need for synchronous telemedicine in al...

Is your vision blurry? A systematic review of home-based visual acuity for telemedicine.

Purpose:To investigate test–retest reproducibility of visual acuities obtained with a popular mobile application (app) and to explore the agreement with the standard clinic charts.Methods:Records of patients who had visual acuity measured during the same routine clinic visit with Snellen chart, Rose

Lam Phung

Papers

Reproducibility and comparison of visual acuity obtained with sightbook mobile application to near card and snellen chart.