The New Eye Chart Isn't a Chart: It's a Virtual Treasure Hunt

Originally published on MedCityNews.com.

Using the 150-year-old eye chart today is a little like riding a horse and buggy around town, in the eyes of Richard Tirendi. To bring vision screening up-to-date and remove some of the human variability and subjectivity in it, Tirendi his eye surgeon friend reinvented the eye chart in the form of a computer game.

Originally published on MedCityNews.com.

It’s called EyeSpy 20/20, and it disguises basic vision screening for kids in the form of a virtual treasure hunt that has them answer questions, match letters and wear an eye patch while playing a game.

Developed by pediatric ophthalmologist Dr. James O’Neil and technology developer Tirendi, the idea behind the software was to improve access to vision screening for school children. Today it’s been used as a screening method for some 200,000 school children ages 5 and up.

For about $5 per student and without the need for a highly trained administrator, EyeSpy 20/20 assesses a child’s distance acquity, or ability to see with a certain amount of resolution, and depth perception. Those are the same metrics captured by a reading of a standard eye chart.

First it guides children through a series of tasks using both eyes together to make sure that binocularly a child can see at the threshold for her age. Then the child puts on an eye patch or colored glasses to assess each eye separately.

That’s an especially important component because amblyopia, better known as lazy eye, is the most common cause of vision loss in children. By recording mouse clicks to measure a child’s reaction time for each eye, the game can detect when a potential vision problem might be present.

From there, the school can print a report or referral to send home to parents recommending that they follow up with a healthcare professional. If amblyopia is caught and treated before the teenage years, it’s more likely to respond to interventions.

Tirendi said that hearing O’Neil recount years of seeing this condition in children, he was moved to join up with him and start a non-profit organization, similarly named VisionQuest 20/20, in 2003.

The pair developed vision screening protocols and translated them into game form over a period of about 10 years. Medical University of South Carolina’s Storm Eye Institute performed an independent, double-blind study of the technology and produced results comparable to those achieved by a certified ophthalmic technician using the gold standard for assessing vision.

Vision 20/20 says signs of other vision problems including strabismus (eye misalignment), cataracts, nearsightedness and astigmatism and color blindness, could also show up through the game. The non-profit has focused the product on schools, since they’re the single largest venue for reaching children.