title: Virtually controlled computerised visual acuity screening in a multilingual Indian population.
abstract: BACKGROUND
  The efficacy of tele-based (virtually monitored) visual acuity (VA) examination in a hospital-based multilingual population was assessed based on subjects from the Outpatient Department of Optometry, School of Allied Health Sciences, Manipal University and Department of Ophthalmology, Kasturba Medical College, Manipal, India.
  
  
  METHODS
  Visual acuity measurement using a computerized VA chart (COMPlog) was done using a telemethod and face-to-face method in a randomized fashion for all subjects. Virtual (remotely operated) control of examination procedure and video-conferencing helped the optometrist positioned elsewhere (different physical location) to remotely operate the COMPlog VA chart and also interact with the subjects. The connection was facilitated using Lync software connected through local area network connections. During tele-examination, instructions were given on subject's language preference (Kannada, Malayalam or English).
  
  
  RESULTS
  Mean age of 96 subjects (three language groups) was 40.3±14.1 years and a Bland-Altman plot showed good agreement with clinically acceptable limits of agreement. The mean difference in VA between the telemethod and face-to-face method was 0.00 logMAR (±0.16), p=0.844. Two methods had good intra-class correlation (0.912, 95% confidence interval 0.868-0.941) and had good agreement across the language groups (kappa>0.7).
  
  
  CONCLUSIONS
  Visual acuity measurements using the telemethod along with native dialect was comparable to conventional face-to-face method in a hospital-based multilingual population. Digital VA testing systems along with communication in native dialect can be effectively integrated into a tele-eyecare model.
authors.affiliation: Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India. srlatha@yahoo.com.
authors.forename: Omana Keasry
authors.initials: OK
authors.lastname: Sreelatha
authors.affiliation: Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India. ramesh.sve@manipal.edu.
authors.forename: S Ve
authors.initials: SV
authors.lastname: Ramesh
authors.affiliation: Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India. judyneendoor@yahoo.com.
authors.forename: Judy
authors.initials: J
authors.lastname: Jose
authors.affiliation: School of Allied Health Sciences, Manipal University, Manipal-576104, Karnataka, India. mredula.ch@gmail.com.
authors.forename: Mredulla
authors.initials: M
authors.lastname: Devassy
authors.affiliation: Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India. skrithica@yahoo.com.
authors.forename: Krithica
authors.initials: K
authors.lastname: Srinivasan
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India; D007802:Language; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D017216:Telemedicine / Q000379:methods*; D014584:User-Computer Interface; D015351:Vision Screening / Q000379:methods*; D014787:Vision Tests / Q000379:methods*
keywords: Allied Health; Asia; Medical; Ophthalmology; Procedures; Public Health