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Abstract

Background/objectives
Glaucoma is a leading cause of blindness worldwide, with the greatest burden in low- and middle-income countries (LMICs) where access to diagnostic services is limited. Portable devices, which are simple to use and comparable to standard tests, may strengthen early detection and referral. This study evaluated selected portable glaucoma assessment devices against standard reference tools in Nigeria and identified which tests or combinations most closely matched a glaucoma diagnosis.

Subjects/methods
In this cross-sectional study at the University of Abuja Teaching Hospital, 312 participants (524 eyes) underwent both portable and conventional testing: Peek CS vs. Pelli-Robson (contrast sensitivity), Peek Acuity vs. LogMAR (visual acuity), iCare vs. Goldmann Applanation Tonometry (GAT) (intraocular pressure), Eyecatcher vs. Humphrey Field Analyzer (visual fields), and Remedio handheld fundus camera vs. slit lamp (optic discs). Agreement, diagnostic accuracy (AUC), completion rates, and patient preference were assessed.

Results
Strong correlations were observed between iCare and GAT IOP (r = 0.96), Peek and LogMAR acuity (r = 0.82), and Remedio handheld fundus camera and slit lamp CDR (r = 0.82). The Remedio handheld fundus camera achieved the highest diagnostic accuracy (AUC = 0.91; sensitivity 82.4%, specificity 99.8%). Combining Remedio with Eyecatcher MD (AUC = 0.86) or iCare IOP (AUC = 0.83) also performed well. Portable devices were faster, had higher completion rates, and were strongly preferred by participants, particularly iCare and Eyecatcher.

Conclusions
Portable devices showed good agreement with standard tools and high acceptability, supporting their potential role in glaucoma screening in resource-limited settings. Further community-based validation is recommended.

Publication Type:	Article
Additional Information:	This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Publisher Keywords:	Epidemiology, Outcomes research
Subjects:	R Medicine > RE Ophthalmology
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Optometry & Visual Science
SWORD Depositor:	Symplectic Administrator

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