Visual Acuity Testing Beyond Traditional Chart: A Narrative Review of PEEK Acuity and ETDRS Chart

Abstract

The ETDRS (Early Treatment Diabetic Retinopathy Review) card is gold standard in visual acuity tests, was the prototype for the logMAR (Logarithm of the Minimum Angle of Resolution) card. A logMAR style smartphone-based application called Portable Eye Examination Kit (Peek Acuity). This review aims to compare the PEEK Acuity application with the ETDRS chart in assessing visual acuity and refractive error, focusing on time efficiency, patient satisfaction, ease of use and comfort. A narrative review was done by digital searching from PubMed, Google Scholar, PEDro, Science Direct, and EBSCO. Two applications applied Peek acuity and ETDRs chart assessment. Both were applied on all participants. Outcome measurement tools were the Patient Satisfaction Questionnaire Short Form (PSQ-18) and topic related questions were added from these two Ease of Care (EOC) questionnaires for assessment of ease and comfort level and Comfort Questionnaire (GCQ). Both methods were effective in enhancing patient outcomes. However, the ETDRS chart was associated with superior performance in terms of visual acuity accuracy and patient satisfaction, while Peek Acuity demonstrated advantages in reduced testing time and improved patient comfort and ease of use.