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New research · Ophthalmology
Optometry and vision science : official publication of the American Academy of Optometry · 18h
Cohort studyOptometry and vision science : official publication of the American Academy of Optometry · 2026

At-home visual acuity in children using a custom iPhone application compared with standardized in-office visual acuity testing.

Tawna L Roberts, Erick D Bothun, Yufeng Zhu … Pediatric Eye Disease Investigator Group
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OphthalmologyCohort study

At-home smartphone visual acuity testing was less reliable in children with worse vision.

At-home visual acuity in children using a custom iPhone application compared with standardized in-office visual acuity testing.

Tawna L Roberts … Pediatric Eye Disease Investigator Group
Optometry and vision science : official publication of the American Academy of Optometry · 2026
Purpose

To validate a custom smartphone application for at-home visual acuity (visual acuity) measurement in children.

Methods

A total of 452 children aged 3-17.5 years participated.

n = 452 children
Results
66%
worse-vision eyes: at-home reading was within 2 lines of the office standard less often
n = 452 children
More results

Comparing at-home app-based with gold-standard visual acuity, in eyes 20/40 or better, 95% (143/151) and 93% (91/98) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = -0.03, older = -0.04; 95% limits-of-agreement half-width (LOA): younger = ±0.26, older = ±0.22).

More results

Comparing in-office app-based visual acuity with gold-standard visual acuity, in eyes 20/40 or better, 98% (160/164) and 94% (99/105) of the younger and older cohorts were within 2 lines, respectively (mean differences: younger = -0.03, older = -0.03; LOA: younger = ±0.22; older = ±0.24).

“
Conclusion · 1 of 2

Our app demonstrated good concordance with the gold standard at home and in the office for eyes with visual acuity of 20/40 or better.

Conclusion · 2 of 2

However, concordance decreased considerably for eyes with visual acuity 20/50 or worse, particularly at home.

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