Schoolchildren who have missed out on crucial eye tests during lockdown can now be screened at home using a new digital app.
One in five UK children is affected by poor eyesight but it can be detected early on with screening during the first year of school. At this point problems can be successfully treated with glasses or patches, if not, they can develop into life-long issues including loss of sight.
Addenbrooke’s Hospital in Cambridge has collaborated with the Cambridgeshire and Peterborough Healthy Child programme screening team, Cambridgeshire County Council and Peterborough City Council, and the county’s community and hospital NHS trusts to provide a pioneering approach for schoolchildren who have missed screening during the Covid restrictions.
The Paediatric Ophthalmology Team at Addenbrooke’s has developed and clinically tested a digital application, called DigiVis, which allows adults and children to test their own vision accurately at home.
Paediatric ophthalmologist, Dr Louise Allen explains how DigiVis works
DigiVis works by allowing you to test your vision at home.
Most of the time when you come into the clinic, you end up seeing a board like this, the child will read down the board and there's somebody taking them through it, which is great, but you do have to come into the hospital, or go to an optometrist to have that vision sight test.
What I've done, is I've actually made a very similar sight test to the one we do in clinic, but it's actually accessible from home.
DigiVis measures the vision at a two metre distance.
The first thing you need to have are two digital devices, which are both connected to the internet. You are going to match the letters that you see on the distant screen, to the ones that are indicated on your smartphone display screen, so you match the letter that the arrow is pointing to. The intelligent thing about the programme is that it works out, by making the letters bigger and smaller, where your actual threshold of vision is, what you can actually see, what's the smallest letter you can see and it uses that to give you your visual acuity score.
It does not prevent a condition, but allows you to detect a condition, early. One of the issues is, for young children you often don't know that they can't see very well, especially if the problem is just in one eye, they act completely normally. As a parent you just might not be aware of it.
If you have a test that you can do at home, especially in the absence of screening, you can actually make sure the child is seeing well, and if not you can do something about it.
DigiVis is a web-based app which enables accurate sight testing for people from the age of four upwards. To use the app, two digital devices such a smartphone and laptop are needed in addition to a few household items to calibrate the system, such as a tape measure or ruler and a standard sized business / store card.
After pairing the devices over the internet, the user matches letters shown on their hand-held device with those displayed at a distance on the other device. The app automatically works out the smallest size letter that can be recognised – a measurement called visual acuity.
Parents are being contacted through their child’s school with information about vision screening and how to access the DigiVis test. Using the DigiVis measurements, the screening team can identify the children who need a full eye examination and organise this.
CUH consultant paediatric ophthalmologist, Dr Louise Allen, said: "It can be difficult for parents to detect if their child has reduced vision, but early treatment is crucial, making screening really important. Using digital technology will allow us to reach those children whose screening has been disrupted by the Covid crisis, to ensure that they don’t miss out.
I want to thank everyone involved in this collaboration, which is an excellent example of teamwork across organisations to find a solution at a time of national crisis. The service will benefit thousands of children in the county, and may be a potential model for vision screening worldwide.Dr Louise Allen - consultant paediatric ophthalmologist
Thanks to backing from the Medical Research Council, Addenbrooke’s Charitable Trust and the local charity Fight Against Blindness, the DigiVis web-app has been fully clinically tested and CE marked, meaning it meets European health and safety requirements.
Working in collaboration with our colleagues across Cambridgeshire and Peterborough has been fantastic. By sharing our resources and expertise, we can ensure children are not missing out on a vital check early in their development.Andrea Graves, Service Lead for Cambridgeshire and Peterborough Healthy Child Programme
“Using DigiVis is just one of the choices we are offering families as an interim solution whilst we operate under the current restrictions. Although clinic appointments are available, I would encourage any families who receive a vision screening letter to try using DigiVis. It is very simple and there are easy-to-follow instructions. If any families need help using DigiVis, have questions about vision screening or have concerns about their child’s vision please call us on 0300 029 50 50 or text us on 07520 649 887.”
Dr Liz Robin, Cambridgeshire and Peterborough's Director of Public Health, added:
This new technology will contribute to the success of our Best Start in Life programme; a multi-agency partnership which aims to ensure all children in Cambridgeshire are healthy, happy, and confident.
“I would like to thank everyone who has been involved in this project in what has been a particularly challenging time. It really does go to show how committed we all are to delivering a safe and effective service to our children at all times.”