Near Visual Acuity Measurements by Community Screeners Using Digital (Peek) Testing Versus Conventional Charts in India.

PURPOSE: The Peek digital near vision test has been previously validated in a trial setting; here it is assessed in clinic (stage 1) and community (stage 2) settings.

METHODS: The study was carried out in the catchment area of Dr. Shroff's Charity Eye Hospital, Mohammadi, Uttar Pradesh, India, with a total of 768 participants. Stage 1 assessed the interobserver variability of Peek near vision impairment (NVI) screening in 168 clinic participants, with three trained community screeners. Stage 2 compared Peek to conventional chart testing for NVI screening using Cohen's kappa coefficient, sensitivity, and specificity and, for quantitative near visual acuity (NVA) measurement, using Bland-Altman limits of agreement (LoA) in 600 participants with two screeners.

RESULTS: In stage 1, interobserver variability using Peek ranged from 96.43% to 98.21% (kappa = 0.92-0.96). In stage 2, there was overall agreement in 95.8% of cases (kappa = 0.91). Peek testing had a sensitivity and specificity of 91.25% (95% confidence interval [CI], 87.22-94.1) and 99.41% (95% CI, 97.86-99.84), respectively. For NVA testing, the 95% LoA between Peek and chart testing were within -0.11 and +0.07 logMAR. Mean test time was 40.3 seconds (95% CI, 38.8-41.7) for Peek versus 46.6 seconds (95% CI, 45.5-47.7) for a conventional chart.

CONCLUSIONS: The previously demonstrated validity of Peek testing was maintained when used by trained community screeners.

TRANSLATIONAL RELEVANCE: The Peek near vision test can be used as a validated method of NVA/NVI measurement in research, clinical and community settings.