Monitoring children’s sight from home
Dr Pete Jones | GR001216
Regular home-monitoring of vision would particularly benefit children, as hospital visits can disrupt schooling. It would allow parents to monitor their child’s vision and potentially spot any changes occurring between appointments.
Dr Pete Jones has been awarded a Springboard Award in collaboration with UCL Child Vision Lab to gather evidence for the feasibility and reliability of home-monitoring of children’s vision.
The World Health Organisation recognises that improving vision measures in children is vital to ensuring early detection and prompt referrals. Currently there is a lack of evidence on whether home-monitoring of vision is feasible and reliable for young children and their families. There are also limited numbers of the child-friendly versions of the necessary tests of visual function.
As part of previous research, Pete and his team developed two novel child-friendly, home-monitoring vision tests:
- contrast sensitivity test for amblyopia, a condition where the eye fails to focus properly
- visual field loss test for childhood glaucoma
These experimental tests combine ordinary, child-friendly computer devices with cutting edge technology including head- and eye-tracking, machine learning and facial recognition. When used in the clinical laboratory, these tests delivered fast and accurate vision assessments, even in young children. But will they be as effective when applied by patients at home?
- Affects 1 in 60 children
- Vision in the affected eye is less clear and the child relies more on the “good” eye
- If untreated it doubles the risk of a child developing a bilateral visual impairment within their lifetime
- Therapies include occluding or blurring the “good” eye, or via balanced binocular viewing therapies
- Treatment efficacy is often limited by less than 50% compliance
- 25% of successfully treated children experience recurrence within one year
- Occurs in 1 in 30,000 births
- Cause of sight loss in up to 5% of children worldwide
- Characterised by visual field loss and elevated intraocular pressure (IOP)
- Symptoms include unusually large and cloudy eyes, sensitivity to light, excessive tearing
Finding a solution
Pete will work with a network of clinicians and patients to evaluate and refine these two vision tests and demonstrate their feasibility in real-world conditions.
In the first phase of the project, children with glaucoma or amblyopia will perform the tests in the UCL Child Vision Lab alongside standard clinical vision assessment. This will allow the team to collect baseline data, optimise sensitivity and specificity for each test.
In the second phase of the project, these groups of children will receive a tablet device to take home for 6 months. They will be asked to perform the vision test at home every two weeks. This will allow the research team to examine practical issues regarding home-monitoring of vision. This will include compliance, which often is a limiting factor in any form of remote monitoring of conditions. It will also evaluate the devices’ ability to remotely monitor progression of the condition.
This work is designed to produce real-world evidence for the feasibility of home-monitoring of vision in children. It will evaluate the reliability of two in-house developed vision tests in children - a patient group that could greatly benefit from improved screening, surveillance and early intervention.
Into the future, home-monitoring of vision could support the earlier detection of disease progression and more personalised and targeted interventions. Substantive cost-savings, via a reduction in clinic appointments could be realised together with allowing more time back into face-to-face clinics enhancing patient experience during the totality of the clinical care pathway.
Dr Pete Jones
Glaucoma, Neuro-ophthalmology/optic neuropathies, Paediatrics, Patient experience