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Invited Commentary
January 14, 2021

Limitations of Measuring Visual Acuity With Remote Applications

Author Affiliations
  • 1Visual Neurophysiology Service, University of the Incarnate Word Rosenberg School of Optometry, San Antonio, Texas
JAMA Ophthalmol. 2021;139(3):347. doi:10.1001/jamaophthalmol.2020.6155

The article by Steren et al1 provides an excellent review of the accuracy of current applications (apps) for presenting high-contrast (black letters, white background) visual acuity (VA) tests on Apple devices, such as iPhones and iPads. The authors appropriately limited their evaluation to apps that provide free access to potential patients as well as specification of viewing distance to optimize accessibility and ensure appropriate character size. The authors note that a prior evaluation of VA apps in 20152 revealed numerous errors in calibration, such as appropriate letter size for specified viewing distances. Given the plethora of new apps and increasing need for telemedicine during the coronavirus disease 2019 (COVID-19) pandemic, the authors astutely sought to update and refine this analysis applicable to ophthalmology, optometry, and multiple health care sectors. Their results further substantiate the inaccuracy of current VA apps for Apple devices, which likely occur in other devices as well.

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