Development and performance evaluation of a Bengali-adapted mHealth app for early detection of impaired visual acuity

This paper presents a comprehensive study on the development and performance evaluation of "<i>Dristi</i>," a mobile health (mHealth) app designed to facilitate eye screening for impaired visual acuity (VA) in Bangladesh. Recognizing the critical importance of vision and the challenges posed by visual impairments, particularly in low-resource settings, this study explores an innovative solution to enhance eye care accessibility. The app, developed for Android devices, integrates features such as VA testing using adapted Bengali letters, color blindness tests, and eye health education, aiming to make eye care more user-friendly and accessible. Inspired by the Snellen chart, the app employs a simplified method for VA assessment, suitable for the constraints of mobile devices. The study involved a cross-sectional comparative design, conducted between June and September 2022, to clinically validate the app's feature of testing distant vision and near vision. Participants were recruited from one government eye hospital, one semi-private eye hospital, one high school, and a private clinic in Bangladesh, encompassing a diverse demographic. The validation study revealed promising results in terms of the app's accuracy, sensitivity, and specificity in both distant and near vision testing, although some variability was observed across different data sources. The study also identified a significant number of participants with diabetes and hypertension, common comorbidities affecting eye health. Overall, "<i>Dristi</i>" demonstrates potential as a valuable tool in the early detection and management of visual impairments in Bangladesh. Its development marks a significant step towards utilizing mHealth solutions to overcome healthcare barriers and improve eye care services in low-resource settings. Future directions include expanding the app's features, enhancing its integration with healthcare systems, and extending its reach to other similar contexts.