Monitoring of Glaucoma at Home – The Future of Glaucoma Care
Glaucoma is the leading cause of irreversible blindness worldwide. For patients with glaucoma, the ability to detect any changes in their peripheral vision (visual field) is critical to their management. However the current practice of visual field testing in clinic is often not frequent enough, and some patient’s vision can deteriorate before their next routine clinic visit. This can lead to delay in confirming a change in clinical condition and result in delay in initiating new treatments.
During COVID-19 period, this problem is exacerbated by many routine glaucoma reviews being postponed. Therefore it has been extremely valuable for Glaucoma Australia to provide the critical research funding to look into innovative Telehealth technology that helps patients with glaucoma to monitor their own visual field at home.
Previous research from my research team showed that it is possible to test visual field using specially designed software, Melbourne Rapid Fields, running on computer/tablet devices that are found in most Australian households1,2. The software is designed to allow self-directed visual field testing by following simple computer voice guidance.
The Glaucoma Australia funding allowed our team to conduct the world’s first long term (18-month) study to examine whether patients with glaucoma is able to perform visual field testing at home reliably and consistently, following an earlier pilot study showed promising results.
To date, we have completed a 12 month study of home monitoring of visual field test with 60 patients enrolled. Our study showed that after a short learning curve, the visual field test results obtain from home correlates strongly with test results performed in clinic. Importantly, our study was uninterrupted by COVID-19 lock-downs. Our study has attracted strong interest internationally with our recent publication in American Journal of Ophthalmology3. This technology will especially benefit patients living in rural and remote locations, who otherwise would need to travel long distances for specialist care.
It is hoped that this research could lead to earlier detection of glaucoma progression compared to standard clinic visits, allowing patients most in need to receive specialist treatment in a timely manner, thereby increasing the likelihood of preserving sight for more patients with glaucoma.
Kong YX, He M, Crowston JG, Vingrys AJ. A Comparison of Perimetric Results from a Tablet Perimeter and Humphrey Field Analyzer in Glaucoma Patients. Translational Vision Science & Technology. 2016; 5(6):2.
Kong YXG. Visual field testing in the era of portable consumer technology, Clinical and Experimental Ophthalmology. May 2018.
Uptake, persistence, and performance of weekly home monitoring of visual field in a large cohort of patients with glaucoma. Prea SM, Kong YXG, Guymer R, Vingrys AJ. American Journal of Ophthalmology Nov 2020