Android mobile applications in eye care

An intelligent decision support system for acute postoperative endophthalmitis: design, development and evaluation of a smartphone application

BACKGROUND

Today, clinical decision support systems based on artificial intelligence can significantly help physicians in the correct diagnosis and quick rapid treatment of endophthalmitis as the most important cause of blindness in emergency diseases. This study aimed to design, develop, and evaluate an intelligent decision support system for acute postoperative endophthalmitis.

METHODS

This study was conducted in 2020-2021 in three phases: analysis, design and development, and evaluation. The user needs and the features of the system were identified through interviews with end users. Data were analyzed using thematic analysis. The list of clinical signs of acute postoperative endophthalmitis was provided to ophthalmologists for prioritization. 4 algorithms support vector machine, decision tree classifier, k-nearest neighbors, and random forest were used in the design of the computing core of the system for disease diagnosis. The acute postoperative endophthalmitis diagnosis application was developed for using by physicians and patients. Based on the data of 60 acute postoperative endophthalmitis patients, 143 acute postoperative endophthalmitis records and 12 non-acute postoperative endophthalmitis records were identified. The learning process of the algorithm was performed on 70% of the data and 30% of the data was used for evaluation.

RESULTS

The most important features of the application for physicians were selecting clinical signs and symptoms, predicting diagnosis based on artificial intelligence, physician-patient communication, selecting the appropriate treatment, and easy access to scientific resources. The results of the usability evaluation showed that the application was good with a mean (± SD) score of 7.73 ± 0.53 out of 10.

CONCLUSION

A decision support system with accuracy, precision, sensitivity and specificity, negative predictive values, F-measure and area under precision-recall curve 100% was created thanks to widespread participation, the use of clinical specialists' experiences and their awareness of patients' needs, as well as the availability of a comprehensive acute postoperative endophthalmitis clinical dataset.

Development and usability evaluation of a mHealth application for albinism self-management

BACKGROUND

Reduced or absence of melanin poses physical, social, and psychological challenges to individuals with albinism. Mobile health (mHealth) applications have the potential to improve the accessibility of information and services while reducing time and costs. This study aimed to develop and evaluate a mHealth application for self-management of albinism.

METHODS

This applied study was conducted in two stages (development and evaluation) in 2022. Initially, the functional requirements were determined, and the conceptual model of the application was then developed using Microsoft Visio 2021. In the second phase, the application was evaluated using the Mobile Application Usability Questionnaire (MAUQ) involving patients with albinism to reflect their views on the usability of the application.

RESULTS

The key capabilities of the application included: reminders, alerts, educational content, useful links, storage and exchange of images of skin lesions, specialist finder, and notifications for albinism-relevant events. Twenty-one users with albinism participated in the usability testing of the application. The users were predominantly satisfied with the application (5.53 ± 1.10; Max: 7.00).

CONCLUSIONS

The findings of this study suggest that the developed mobile application could assist individuals with albinism to effectively manage their condition by considering the users' requirements and services that the application should deliver.

Challenges and impact of COVID-19 lockdown on Indian optometry practice: A survey-based study

PURPOSE

The Indian government announced a nationwide lockdown as a preventive measure to control the prevailing COVID-19 pandemic. This survey was developed and conducted to assess the impact of lockdown on Indian optometry practice.

METHODS

A survey questionnaire was designed and circulated across the optometrists practicing in India through multiple social media platforms. All the data were extracted and only valid response were analyzed and reported.

RESULTS

A total of 691 optometrists participated in the survey. Most of the participants (22.25%) were in private practice followed by academics (14.89%). Among the valid responses collected, it was found that 43.37% of the respondents were consulting patients during the lockdown. Of these, 27.17% of optometrists were examining infectious cases and 48.68% were examining all the patients who came for consultation. Approximately 50.94% of the participated optometrist had begun telephonic/e‑mail/video consultations. In addition, 64.48% reported that optometrists were at an equal risk of clinching COVID‑19 on comparison with other domains during patient examination. Nearly 30.44% respondents felt that optometrists would face challenges in approaching the patient post COVID-19 considering the close working distance.

CONCLUSION

A proportion of optometrist have switched to some form of teleconsultation in order to aid patients during this prevailing pandemic. Regulatory bodies should issue appropriate guidelines regarding the safe optometry practice for the betterment of both patient and practitioners during face-to-face consultation.

A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study

Orthokeratology (OK) lens wear is an effective modality to inhibit axial elongation in myopic children. Willingness for commitment from both parents and children contributes to the success of OK treatment. We aimed to develop and assess the usability of a mobile application on OK lens wear by quantitatively and qualitatively evaluating parents with myopic children and eye care professionals (ECPs). Moreover, the preliminary outcome was also evaluated in this study. The app was developed and tested using a co-design approach involving key stakeholders. Two prototype tests were conducted during the feasibility and utility assessment. The app features include self-reported compliance documentation, analytics, and personalized and generalized messages for compliance behaviors of OK lenses. After the trial period, the full usage of app functions ranged from 40% to 60% among the enrolled parents. After app implementation, the compliance with follow-up visits substantially improved. Qualitative data show that the high-satisfaction app functions reported by parents were the app’s reminder and axial length recording, although it was recommended that the number of compliance questions should be reduced to minimize the survey completion time. Additionally, who should complete the recording of the axial length data as well as the management and reminder for the follow-up visit remained controversial. This is the first app developed to improve parents of myopic children’s compliance with OK lens wear and to assist ECPs and parents in collaboratively monitoring and managing the use and care of OK lenses among myopic children. This study highlights the importance of interdisciplinary collaboration in the design, development, and validation of such an app.

Utility of teleconsultation in accessing eye care in a developing country during COVID-19 pandemic

OBJECTIVE

To evaluate the utility of teleconsultation in the provision of eye care services during the COVID-19 lockdown. Disparities in the consultation burden of sub-specialities and socio-demographic differences in teleconsultation utilization were also assessed.

METHODS

Al-Shifa Trust Eye Hospital Rawalpindi began audio and video teleconsultation using broadband telecommunication services during the lockdown. Patients' and consultations' data gathered during the first three weeks after the commencement of this programme were compared with data from the four weeks prior to lockdown. The weekly consultation ratio and overall consultation burden of sub-specialities were measured. Chi-Square tests of association determined the relationship between different variables (socioeconomic status and consultation characteristics) and consultation modality (on-site vs online).

RESULTS

In total, 17507 on-site consultations (4377/week) were conducted compared to 1431 teleconsultations (477/week), which maintained 10.89% of the weekly pre-lockdown eye care services. The post-lockdown teleconsultation programme saw a relatively higher percentage of service utility among female (47.09% vs 44.71%), younger-age (31.33±19.45 vs 41.25±23.32 years) and higher-socioeconomic-status (32.21% vs 0.30%) patients compared to pre-lockdown on-site consultations. The most common indication for teleconsultation was red-eye (16.70%). While cornea and glaucoma clinics maintained most of the pre-lockdown services (30.42% and 29% respectively), the highest dropout was seen in optometric and vitreoretinal services supporting only 5.54% and 8.28% of pre-lockdown services, respectively.

CONCLUSION

Digital initiatives could partially maintain eye care services during the lockdown. Focused strategies to improve teleconsultation utilization are required during the pandemic and beyond.

Rethinking Elective Cataract Surgery Diagnostics, Assessments, and Tools after the COVID-19 Pandemic Experience and Beyond: Insights from the EUROCOVCAT Group

The progressive deterioration of the visual function in patients on waiting lists for cataract surgery has a negative impact on their quality of life, especially in the elderly population. Patient waiting times for cataract surgeries in many healthcare settings have increased recently due to the prolonged stop or slowdown of elective cataract surgery as a result of coronavirus disease 19 (COVID-19). The aim of this review is to highlight the impact of such a "de-prioritization" of cataract surgery and to summarize some critical issues and useful hints on how to reorganize cataract pathways, with a special focus on perioperative diagnostic tools during the recovery phase and beyond. The experiences of a group of surgeons originating from nine different countries, named the European COVID-19 Cataract Group (EUROCOVCAT), have been combined with the literature and recommendations from scientific ophthalmic societies and healthcare institutions. Key considerations for elective cataract surgery should include the reduction of the number of unnecessary visits and examinations, adoption of precautionary measures, and implementation of telemedicine instruments. New strategies should be adopted to provide an adequate level of assistance and to guarantee safety conditions. Flexibility will be the watchword and regular updates would be necessary following scientific insights and the development of the pandemic.

Rehabilitation of Sport-Related Concussion

This article provides a summary of clinical assessment methods and nonpharmacologic rehabilitation techniques used for concussed patients. It describes concussion-relevant physical examination methods to identify underlying symptom generators. This approach allows practitioners to prescribe targeted rehabilitation therapies to treat postconcussion symptoms. Evidence-based rehabilitation approaches include cervical rehabilitation, vestibulo-ocular rehabilitation, and sub-symptom threshold aerobic exercise.

Ophthalmology Practice During the Coronavirus Disease 2019 Pandemic: The University of Pittsburgh Experience in Promoting Clinic Safety and Embracing Video Visits

The coronavirus disease 2019 pandemic has led to widespread change as public health strategies for containment have emphasized social distancing and remaining at home. These policies have led to downscaled clinic volumes, cancellation of elective procedures, enhanced personal protective strategies in the clinic, and adoption of telemedicine encounters. We describe the evidence-based practical approach taken in our ophthalmology department to continue delivering eye care during the pandemic by rescheduling visits, enhancing clinic safety, and adopting virtual video encounters.