Eyeworld

EW GLAUCOMA 54 April 2015 With the app, screenings were more efficient than with the stan- dard Humphrey SITA test, only taking about one-third of the time, with results correlating closely to this traditional test, Dr. Johnson found. About 80% of the time, the results of the 2 tests were in agree- ment, he reported. "I think that's remarkable," he said. "I'm enthu- siastic that it's going to get up to 90% when we have further improve- ments." He is hopeful that strategies previously used to improve results with the frequency doubling testing may also improve outcomes with the iPad in more mild cases where the app was found to not be as reliable. For example, with standard frequency doubling, if a person missed seeing a target initially, this point would be presented again a second time. "That improves the performance quite a bit, and we and several labo- ratories have shown that going back and retesting will eliminate a lot of those false alarms," he said. During the study, Dr. Johnson, who has about 35 years of experi- ence, was reading the test results himself. However, interpreting results is something that could someday be done automatically in most cases. "In the future that could automatically be done to take care of 90% to 95% of cases," he said. "However, there's always going to be a grey zone where you're going to need expert opinion." Clinical implications Dr. Johnson is optimistic about what using the iPad for glaucoma screen- ing means from a clinical perspec- tive. "I think that this provides an option for underdeveloped countries to be able to improve the access to eyecare," he said. "I think that it makes it much more reasonable to be able to do population-based screening." He has plans for expand- ing into India and would also like to use this tool in Africa. Meanwhile, in the U.S. he envisions leading vision agencies as potentially adopting the iPad test for screening. In addition, he sees this as something that could be used for home testing to determine if there has been a change in vision over time. Yet another possible application could be at doctors' offices where, with the aid of goggles, patients could undergo the screening in the waiting room to increase efficiency. "The results would be there for the doctor by the time [patients] get to see the doctor," Dr. Johnson said, adding that would be more useful than having the patient see the prac- titioner, only to be directed to take tests and come back again. "I think that cost containment and efficiency is going to be more of an issue in the next few years the way things are going with medicine," Dr. Johnson said. EW Editors' note: Dr. Johnson has no finan- cial interests related to his comments. Contact information Johnson: chris-a-johnson@uiowa.edu "I'm very encouraged by what we were able to do to date because we've been able to detect most of the glaucoma and diabetic eye disease that was significant or meaningful for the person," he said. "It was very good at being able to pick up moderate and advanced eye disease." iPad ophthalmic screening continued from page 52

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