USA and telemedicine: FDA approved first online vision test

By Cristiano Antonino Last updated Sep 1, 2022

The Food and Drug Administration (FDA) on August 16 approved the first online visual acuity test made by the telehealth company Visibly. This clearance will allow adults ages 22 to 40 to evaluate their vision from the convenience of their homes

The FDA approval may increase access for people who are in need of a renewed prescription for glasses or contacts but cannot travel to an appointment

However, it’s not a replacement 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 board-certified ophthalmologist at Manhattan Eye.

“Overall, this remote vision test is helpful. If you really want an accurate prescription, and there’s a way to get to a doctor’s office, I would still say that that’s a better option.”

According to Visibly, the online visual test is best for “people whose vision has not changed, have recently completed a comprehensive eye exam,” and are looking to renew an expired prescription.

The test is not a substitute for, nor does it provide screening or diagnosis for eye health or eye diseases, which should be performed by a licensed provider, according to the FDA

Paul Foley, Visibly’s chief operating officer, said in a press release that the online vision test will increase at-home use and complement in-person eye care.

The test takes about six minutes to complete and 90% of the prescriptions are issued within 24 hours, according to the company.

It’s Still Important to Get a Comprehensive Eye Exam

Rapoport said the service cannot replace a comprehensive screening for patients who need intense treatment.

“If you have more complicated needs, like having a progressive pair of glasses or bifocals, then that’s not as easy to measure,” she said.

The digital visual acuity test cannot assess one’s eye health or check for diseases like glaucoma.

And it may not be able to evaluate astigmatism, where people may have a slightly unusual cornea shape, according to Rapoport.

It’s much easier to evaluate astigmatism in person with a trained professional than on a self-administered test on a computer, she said.

“A cornea can be shaped not like a perfect basketball, but more like a football, where one side is longer than other sides,” Rapoport said.

“It’s just a different measurement, but it’s hard to measure on a computer screen at home.”

Accurately measuring eye shape and astigmatism is important for identifying the cause of double vision, improperly corrected vision, and headaches, she added.

For people who need separate prescriptions to see objects clearly at different distances, it’s challenging 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 consists of 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 eye’s general health with a slit lamp—a microscope with a bright light. They can also check how your pupils respond to light and for conditions like glaucoma and diabetic retinopathy with a drop of medication that fully dilates your pupils.

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

When Should You Use an Online Vision Test Then?

An at-home visual acuity test can benefit people who have busy schedules or cannot easily travel to their eye care providers. Sometimes, they might 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 that their prescription hasn’t changed,” Rapoport said.

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

“There’s absolutely no way that you’re getting a better, more accurate prescription doing this,” Rapoport said.

“You’re getting convenience.”

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