City Research Online

Abstract

Background
Patients often spend significant time in clinic waiting rooms. This study assessed the feasibility of using this “wasted” time to perform self-administered vision assessments directly within the waiting area.

Methods
Glaucoma patients attending routine appointments were asked to complete either a pen-and-paper (SpotChecks) or digital (PopCSF) contrast sensitivity (CS) test. Ambient illuminance, background noise, and crowd levels were recorded to assess potential environmental confounds. Test durations and patient feedback were recorded. Visual-Functioning Index-7 (VF-7) and Pelli-Robson CS (reference) test results were collected for comparison.

Results
Of 173 patients approached, 155 (89.6%) agreed to participate, and 151(97.4%) participants completed testing before their appointment (77/78 pen-and-paper; 74/74 digital). Environmental factors had no significant impact (all P > 0.05). Median completion times were 3.0 {2.6–4.5} minutes (pen-and-paper) and 2.5 {2.0–3.5} minutes (digital). Age did not impact the pen-and-paper test duration (P = 0.944) but weakly correlated with the digital test duration (rdigital = 0.27, P = 0.020). Functional CS scores correlated with Pelli-Robson reference measurements (rpen-and-paper = 0.81; rdigital = 0.62), age (rpen-and-paper = –0.58; rdigital = –0.37), logMAR visual acuity (rpen-and-paper = –0.42; rdigital = –0.44), and visual field mean deviation scores (rpen-and-paper = –0.54; rdigital = –0.63). Both tests were highly acceptable to patients ( > 80% on all questions). Visit durations were longer for participants (109 vs 88 min, P = 0.007), but this was attributed to consenting and related research activities rather than the tests themselves.

Conclusions
This proof-of-concept study demonstrates that it is feasible for patients to self-administer portable vision tests in clinic waiting rooms. Using CS as a representative example, this approach may enable additional data collection, potentially improving patient management, clinic flow, and/or patient satisfaction.

Publication Type:	Article
Additional Information:	© The Author(s) 2026. 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/.
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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