Measuring Vision at Home in 2023.

Introduction: The ability to measure a patient's visual acuity at home (HVA) is by far the most desired remote telemedicine capability sought by ophthalmologists. Methods: A systematic literature review was done using Pubmed to search for publications from 2010 to 2022 in English reporting on 10 studies that compared a patient's HVA to the clinic visual acuity (CVA). Results: Approaches to measuring HVA included using a phone-based application, a physical chart, a computer, and a website. The most accurate of these was the use of personal computers (COMPlog, Macustat, Web based test) at home with a bias of 1 letter. The most accessible and reliable was the use of a printable visual acuity chart, available in the public domain, which had adifference between HVA and CVA of 1 to 3.5 letters. Phone apps (Verana Vision) and stand-alone websites (Farsight.com) both had a greater mean difference of about 6 letters, respectively,with a moderate correlation coefficient. Discussion: Overall, all three methodologies demonstrated a good negative predictive value demonstrating their potential use as an effective screening tool to flag drastic vision decline between clinic visits.

Determinants of compliance with outpatient examinations for infants at risk for retinopathy of prematurity.

PURPOSE: To assess the level and the determinants of compliance with outpatient retinopathy of prematurity (ROP) examination appointments at a tertiary academic center. METHODS: The medical records of babies scheduled for outpatient ROP examination between January 1, 2022, and December 31, 2022, were reviewed retrospectively. Data collected included appointments scheduled and attended, birth weight, gestational age, ROP staging at discharge, maternal ethnicity (self-identified), household type, proximity to hospital and median family income (US Census based on home zip codes). Univariate and multivariable analyses were performed. A P value of <0.05 was considered significant. RESULTS: The records of 66 babies were analyzed. Forty-nine babies (74%) attended all scheduled ROP examination appointments (fully compliant). The mean appointment compliance rate was 86%, with a 1.5% no-show rate. Seven children (11%) required the intervention of Child Protective Services. One baby was never seen in the clinic. In unadjusted analysis, maternal ethnicity (P = 0.028) and median family income lower than the national average (P = 0.049) were sociodemographic factors associated with lower compliance. Clinical factors associated with lower compliance were lower gestational ages (P = 0.005) and lower birth weight (P = 0.006). In multivariable logistic regression adjusting for all candidate predictors, only birth weight remained significantly associated with lower compliance (P = 0.036). CONCLUSIONS: Clinical and sociodemographic factors may be associated with compliance with outpatient ROP examination recommendations. Extremely low-birth-weight babies were at the greatest risk for noncompliance.

Patient's Perceptions of Importance of Discontinuing Antithrombotic Medication Before Oculoplastics Surgery.

This study aims to analyze patients' perspectives to ultimately gain insight into the patients understanding in 3 broad categories: their understanding of how their medications, supplements, and over-the-counter drugs work, their understanding of the risks these agents pose in a surgical setting, and their preferences for the continued use of the agents during and after oculoplastic surgery. To obtain these data, the authors prospectively surveyed 129 patients who had an oculoplastic surgery clinical evaluation at our tertiary care academic facility. Because no previously validated questionnaire on this topic existed, the authors utilized a novel questionnaire the authors developed. For antithrombotic medications, about 60% of patients felt there were risks associated both with stopping and continuing the agent during surgery. For antithrombotic supplements, more patients answered there were risks associated with continuing the agents during surgery versus stopping the agents during surgery (40% versus 25%, respectively). There was a relationship between patients' knowledge that they were on an antithrombotic prescription and their understanding of the risks associated with antithrombotic usage during surgery as well as sudden discontinuation of the prescription. With an understanding of the patient's point of view, surgeons will be equipped to have multifaceted conversations with their patients surrounding their medications, systemic health, and oculoplastic surgery.