Evaluation of a visual acuity eHealth tool in patients with cataract

J Cataract Refract Surg. 2023 Mar 1;49(3):278-284. doi: 10.1097/j.jcrs.0000000000001108. Epub 2022 Dec 6.


Purpose: To validate the Easee web-based tool for the assessment of visual acuity in patients who underwent cataract surgery.

Setting: University Eye Clinic Maastricht, Maastricht, the Netherlands.

Design: Prospective method comparison study.

Methods: Subjects aged between 18 and 69 years who underwent cataract surgery on 1 or both eyes at the Maastricht University Medical Center+ were eligible to participate in this study. The uncorrected (UDVA) and corrected distance visual acuity (CDVA) assessments were performed using the web-based tool (index test) and conventional ETDRS and Snellen charts (reference tests). The outcomes of the different tests were expressed in logMAR, and a difference of <0.15 logMAR was considered clinically acceptable.

Results: 46 subjects with 75 operated eyes were included in this study. The difference of the UDVA between the web-based tool and ETDRS or Snellen was -0.05 ± 0.10 logMAR ( P < .001 [0.15; -0.26]) and -0.04 ± 0.15 logMAR ( P = .018 [0.24; -0.33]), respectively. For the CDVA, these differences were -0.04 ± 0.08 logMAR ( P < .001 [0.13; -0.21]) and -0.07 ± 0.10 logMAR ( P < .001 [0.13; -0.27]), respectively. The Pearson correlation coefficients between the web-based tool and ETDRS were maximally 0.94 and compared with Snellen 0.92. In total, 73% to 88% of the visual acuity measurement differences were within 0.15 logMAR.

Conclusions: The web-based tool was validated for the assessment of visual acuity in patients who underwent cataract surgery and showed clinically acceptable outcomes in up to 88% of patients. Most of the participants had a positive attitude toward the web-based tool, which requires basic digital skills.

MeSH terms

  • Academic Medical Centers
  • Adolescent
  • Adult
  • Aged
  • Cataract Extraction*
  • Cataract*
  • Humans
  • Middle Aged
  • Prospective Studies
  • Visual Acuity
  • Young Adult