Ease of Use and Acceptability of an at-Home Vision Screening Kit in a Primarily Non-English Speaking, Underserved Population

Timothy Do, Michael Nguyen, Kara Her, Bryan Kuo, Kevin Leung Chau, Madeleine Lu, Michele C Lim Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USACorrespondence: Michele C Lim, Department of Ophthalmology & Vision Science, University of California, Davis, Tschannen Eye Institute, 4860 Y Street, Sacramento, CA, 95817, USA, Tel +1 (916) 734-6602, Fax +1 (916) 734-0411, Email [email protected]: The study aims to investigate the ease of use, acceptability, and accuracy of a simple at-home vision screening kit in a non-English speaking socially disadvantaged population.Design: This is a single site, prospective, cross-sectional study.Methods: Patients at a clinic that provided free medical care to an urban, predominantly Asian, underserved population were invited to participate in this study. We designed a program for at-home vision assessment, which consisted of a simple at-home vision kit (Rosenbaum near card, Amsler grid) and instructions for use given in verbal and written form in the patient’s own language. Testing was performed in each eye during an in-person visit. Patients were then asked to test at-home and were later contacted by telephone to record the results. A survey questionnaire assessing the ease of use and acceptability of the vision kit was then administered.Results: One hundred and one of 141 patients completed the study. Of those patients, 60.4% were female, 79.2% were Asian, 95% were born outside of the United States, 81.2% did not speak English as their primary language, 47.5% were not enrolled in health insurance, and 67.3% expressed difficulty in accessing eye care. The results of our survey (n = 101) demonstrated that 90% would continue utilizing the vision screening kit, 91.1% would recommend the vision screening kit to others, and 82.2% rated the vision screening kit as extremely easy to use. The Spearman’s rank correlation coefficient for the in-person VA logMAR scores and at-home VA logMAR scores was calculated to be ρ = 0.862, p < 0.0001 in the right eye and ρ = 0.834, p < 0.0001 in left eye.Conclusion: Our tailored protocol and design of a simple at-home vision screening kit was widely accepted and easy to use by an underserved population in which English was not the primary spoken language. The kit demonstrated excellent correlation between in-person and at-home VA results.Keywords: socioeconomic factors, language barriers, vision care accessibility, visual acuity repeatability, tele-ophthalmology