Evaluating a web‐based visual acuity and refractive error self‐assessment tool in myopic children

Introduction Demands for myopia management are rising. A web‐based tool that allows home‐performed self‐assessments of visual acuity (VA) and refractive error may enable hybrid care pathways and aid in identifying those with deteriorating visual performance. The tool has been validated in adult populations, but has yet to be evaluated in children. This study compared home‐performed VA and refraction self‐assessments to conventional measurements obtained at the clinic in a population of myopic children. Methods Myopic children aged ≥6 years old were invited to perform web‐based eye tests at home, assisted by a parent. At two myopia control clinics, they also underwent measurements of VA using a Snellen chart and refractive error using cycloplegic autorefraction. Agreement between the tests, repeatability of the web‐based test and associations between clinical characteristics and web‐based test accuracy were evaluated. Results A total of 147 children were enrolled, of whom 116 (51% male; mean age 13 ± 3 years; mean spherical equivalent refraction (SEQ) −5.58 ± 3.05) performed the web‐based tests at home. Overall, the home‐performed VA self‐assessment and the Snellen chart assessment at the clinic agreed well (mean difference 0.03 ± 0.11 logMAR). A significant proportional bias was identified (β 0.65, p