Colour vision testing on smartphones among patients with multiple sclerosis and approach to smartphones applications in clinical practice


Ruta Kinderyte1, Egle Baliutaviciute2, Saulius Galgauskas3, Jurate Vilma Balciuniene2

1Medical Academy, Lithuanian University of Health Sciences, Kaunas 44307, Lithuania 2Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas 50009, Lithuania

3Clinic of Ear, Nose, Throat and Eye Diseases, Faculty of Medicine, Vilnius University, Vilnius 08410, Lithuania


Aim: To test colour vision using Ishihara test booklet and EyeHandbook application on smartphones and compare the results of multiple sclerosis patients and healthy people. Assess approach to the use of smartphone applications in clinical practice. Methods: In 2015/2016 October −March a prospective study of the multiple sclerosis patients (study group) and healthy people (control group) was done by testing colour vision using 12 Ishihara booklets and the EyeHandbook application on smartphones. Both eyes were tested in controlled conditions. Correctly identified plates were counted, vision acuity tested and information about gender, age, duration of the disease and its type was collected. Also,people were interviewed on the approach to innovative technologies. Statistic analysis was done using “Microsoft Excel 2010”, SPSS 20 and paired-samples t test, independent-samples t test, linear regression. p values were considered significant at p<0.05. Results: In the study group (n=44) mean score of correctly identified plates with the Ishihara booklet was 8.34±3.28 and with EyeHandbook 8.89±3.13 whereas in the control group (n=88) mean score respectively was 11.89±0.39 and 11.94±0.28, with a difference of two methods in study group t(43)=-0.55, p=0.028 and in control group t(87)=-1.68, p=0.096. Using the Ishihara booklet as the “gold standard”, the sensitivity of “EyeHandbook” was 83.30% and specificity 98.00%. Older multiple sclerosis patients correctly identified less plates than younger from Ishihara booklet (coefficient -0.115, p=0.038) and EyeHandbook (p>0.05). Patients who have had the disease longer identified less plates from Ishihara booklet (coefficient -0.211, p=0.002) and EyeHandbook (coefficient  -0.179, p=0.008). 59 (89.39%) of the respondents had a smartphone. 22 (13.90%) had downloaded medical or medical-related applications, 19 (86.36%) noticed that applications are useful in clinical practice. 55 (83.4%) said that a doctor who use the latest technologies is competent.Conclusion: Multiple sclerosis patients correctly identified more plates using EyeHandbook than the Ishihara booklet. The amount of correctly identified plates from the Ishihara booklet is associated with duration of the multiple sclerosis, there is inconsistent information if it is associated with age.The majority of ubjects use and welcome the use of smart technologies in clinical practice. Key words:colour vision, Ishihara, smartphone, applications, comparison