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Abstract

Background: Glaucoma services are under unprecedented pressure. The UK Healthcare Safety Investigation Branch recently called for new ways to identify glaucoma patients most at risk of developing sight loss, and of filtering-out false-positive referrals. Here we evaluate the feasibility of one such technology, “Eyecatcher”: a free, tablet-based ‘triage’ perimeter, designed to be used unsupervised directly within clinic waiting areas. It does not require a button or headrest: patients are simply required to look at fixed-luminance dots as they appear.

Methods: Seventy-seven people were tested twice using Eyecatcher (one eye only) while waiting for a routine appointment in a UK glaucoma clinic. The sample included individuals with an established diagnosis of glaucoma, and false-positive new referrals (no visual field or optic nerve abnormalities). No attempts were made to control the testing environment. Patients wore their own glasses and received minimal task instructions.

Results: Eyecatcher was fast (median: 2.5 mins), produced results in good agreement with standard automated perimetry (SAP), and was rated as more enjoyable, less tiring, and easier to perform than SAP (P<0.001). It exhibited good separation (ROC=0.97) between eyes with advanced field loss (Mean Deviation <-6 dB) and those within normal limits (MD > -2 dB). And it was able to flag two thirds of false-positive referrals as functionally normal. However, eight people (10%) failed to complete the test twice, and reasons for this limitation are also discussed.

Conclusions: Tablet-based eye-movement perimetry could potentially provide a pragmatic way of triaging busy glaucoma clinics (flagging high-risk patients and possible false-referrals).

Publication Type:	Article
Additional Information:	© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Publisher Keywords:	glaucoma; visual fields; static perimetry; eye-movements; triage
Subjects:	R Medicine > RE Ophthalmology
Departments:	School of Health & Psychological Sciences > Optometry & Visual Sciences
SWORD Depositor:	Symplectic Administrator

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