Using an open-source tablet perimeter (Eyecatcher) as a rapid triage measure for glaucoma clinic waiting areas.
BACKGROUND
Glaucoma services are under unprecedented strain. The UK Healthcare Safety Investigation Branch recently called for new ways to identify glaucoma patients most at risk of developing sight loss, and of filtering-out false-positive referrals. Here, we evaluate the feasibility of one such technology, Eyecatcher: a free, tablet-based 'triage' perimeter, designed to be used unsupervised in clinic waiting areas. Eyecatcher does not require a button or headrest: patients are simply required to look at fixed-luminance dots as they appear.


METHODS
Seventy-seven people were tested twice using Eyecatcher (one eye only) while waiting for a routine appointment in a UK glaucoma clinic. The sample included individuals with an established diagnosis of glaucoma, and false-positive new referrals (no visual field or optic nerve abnormalities). No attempts were made to control the testing environment. Patients wore their own glasses and received minimal task instruction.


RESULTS
Eyecatcher was fast (median: 2.5 min), produced results in good agreement with standard automated perimetry (SAP), and was rated as more enjoyable, less tiring and easier to perform than SAP (all p<0.001). It exhibited good separation (area under receiver operating characteristic=0.97) between eyes with advanced field loss (mean deviation (MD) < -6 dB) and those within normal limits (MD > -2 dB). And it was able to flag two thirds of false-positive referrals as functionally normal. However, eight people (10%) failed to complete the test twice, and reasons for this limitation are discussed.


CONCLUSIONS
Tablet-based eye-movement perimetry could potentially provide a pragmatic way of triaging busy glaucoma clinics (ie, flagging high-risk patients and possible false-positive referrals).
['Jones|Pete R|PR|0000-0001-7672-8397', 'Lindfield|Dan|D|0000-0002-7232-9767', 'Crabb|David P|DP|0000-0001-8754-3902']
D000368:Aged D005260:Female D005901:Glaucoma D006801:Humans D007429:Intraocular Pressure D008297:Male D008875:Middle Aged D009898:Optic Disk D012372:ROC Curve D014218:Triage D058609:Visual Field Tests D014794:Visual Fields
glaucoma diagnostic tests/Investigation field of vision psychophysics