The FDA has approved the first online vision test. What can it do?

Key points to remember

  • The FDA has approved a home visual acuity test that allows people to assess their vision online.
  • This test will allow people to renew their prescriptions if they have recently had a comprehensive eye exam and they know their vision has not changed.
  • It is not a substitute for a routine in-person eye exam, as it cannot check the general health of your eyes.

The Food and Drug Administration on August 16 approved the first online visual acuity test performed by telehealth company Visibly. This authorization will allow adults between the ages of 22 and 40 to assess their vision from the comfort of their own home.

FDA approval may increase access for people who need a refill prescription for eyeglasses or contacts but can’t make it to an appointment. However, this is not a substitute for an in-person eye exam.

“During the pandemic, a lot of people delayed elective health care that was really important,” said Yuna Rapoport, MD, MPH, a Manhattan Eye board-certified ophthalmologist. “Overall, this remote viewing test is useful. If you really want an accurate prescription and there’s a way to get to a doctor, I’d still say that’s a better option.

What is a visual acuity test?

A visual acuity test is one of the most important parts of an eye exam. It measures the quality of your vision by testing the smallest letters or pictures that you can read clearly.

Obviously, the online eye test is best for “people whose vision has not changed, who have recently had a comprehensive eye exam” and are looking to refill an expired prescription.

The test also does not replace or provide screening or diagnosis of eye health or eye disease, which must be performed by an approved provider, according to the FDA.

Paul Foley, COO of Visibly, said in a Press release that the online vision test will increase home use and complement in-person eye care. The test takes about six minutes and 90% of prescriptions are issued within 24 hours, according to the company.

It’s always important to get a comprehensive eye exam

Rapoport said the service cannot replace comprehensive screening for patients who need intense treatment. “If you have more complicated needs, like having a pair of progressive glasses or bifocals, it’s not as easy to measure,” she said.

The digital visual acuity test cannot assess eye health or look for diseases like glaucoma. And it may not be able to assess astigmatism, where people may have a slightly unusual corneal shape, according to Rapoport. It’s much easier to assess astigmatism in person with a trained professional than on a self-administered test on a computer, she said.

“A cornea may not be shaped like a perfect basketball, but more like a soccer ball, where one side is longer than the other,” Rapoport said. “It’s just a different metric, but it’s hard to measure on a home computer screen.”

Accurately measuring eye shape and astigmatism is important to pinpoint the cause of double vision, poorly corrected vision and headaches, she added.

For people who need separate prescriptions to see objects clearly at different distances, it’s difficult to measure their vision with Visibly’s digital test.

“For progressive needs, you’re trying to figure out what the person’s near vision would be, but it’s really hard to measure that without giving a few different options at different distances,” Rapoport said.

What else is involved in an eye exam?

A routine eye exam includes many parts in addition to a visual acuity test.

During an eye exam, providers can measure eye pressure with the “air puff test” or examine your general eye health with a slit lamp, a bright light microscope. They can also check how your pupils react to light and for conditions such as glaucoma and diabetic retinopathy with a drop of medication that fully dilates your pupils.

“A lot of people don’t know they have one of these issues until it’s too late. That’s why it’s important to go see a doctor,” Rapoport said.

When should you use an online vision test then?

A home visual acuity test can benefit people who have busy schedules or cannot easily travel to their eye care providers. Sometimes they may just need to renew their driver’s license or contact lens prescription.

“It’s best for patients whose eyes are young and healthy and who can tell their prescription hasn’t changed,” Rapoport said.

For people who want a more in-depth evaluation, she continues to recommend making an appointment in person.

“There’s absolutely no way to get a better, more accurate prescription by doing this,” Rapoport said. “You get convenience.”

What this means for you

If you recently had a comprehensive eye exam and your vision hasn’t changed, you can now renew your eyeglass or contact lens prescriptions with an online visual acuity test. It does not replace a routine eye exam, as it does not provide a comprehensive assessment of your eye health.

About Marion Alexander

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