Evaluation of a visual acuity eHealth tool in patients with cataract

Purpose: To validate the Easee web-based tool for the assessment of visual acuity in patients who underwent cataract surgery. Setting: University Eye Clinic Maastricht, Maastricht, the Netherlands. Design: Prospective method comparison study. Methods: Subjects aged between 18 and 69 years who underwent cataract surgery on 1 or both eyes at the Maastricht University Medical Center+ were eligible to participate in this study. The uncorrected (UDVA) and corrected distance visual acuity (CDVA) assessments were performed using the web-based tool (index test) and conventional ETDRS and Snellen charts (reference tests). The outcomes of the different tests were expressed in logMAR, and a difference of <0.15 logMAR was considered clinically acceptable. Results: 46 subjects with 75 operated eyes were included in this study. The difference of the UDVA between the web-based tool and ETDRS or Snellen was -0.05 +/- 0.10 logMAR (P<.001 [0.15; -0.26]) and -0.04 +/- 0.15 logMAR (P=.018 [0.24; -0.33]), respectively. For the CDVA, these differences were -0.04 +/- 0.08 logMAR (P <.001 [0.13; -0.21]) and -0.07 +/- 0.10 logMAR (P <.001 [0.13; -0.27]), respectively. The Pearson correlation coefficients between the web-based tool and ETDRS were maximally 0.94 and compared with Snellen 0.92. In total, 73% to 88% of the visual acuity measurement differences were within 0.15 logMAR. Conclusions: The web-based tool was validated for the assessment of visual acuity in patients who underwent cataract surgery and showed clinically acceptable outcomes in up to 88% of patients. Most of the participants had a positive attitude toward the web-based tool, which requires basic digital skills. Copyright (c) 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of ASCRS and ESCRS