Estudio del uso de dispositivos móviles para la monitorización de hábitos digitales y el seguimiento remoto de la progresión de la miopía y la presbicia

Laburpena

The digital age has transformed visual care making it possible to perform remote optometric consultations and visual tests (tele-optometry). However, excessive use of electronic devices could cause the onset or progression of myopia. A series of studies are carried out that analyze the use of smartphones as a tool, both for the measurement of illuminance, the time and distance of use (digital habits) and its possible effects on myopia, as well as monitoring the possible refractive change and visual acuity (VA) of the user. In a first study, objective measurements of digital habits were taken in a group of young people in which no type of alert was used (passive group) and in another group in which minimum use, distance or lighting alerts were used (active group). The active group presented a mean distance of use of the device of 343 ± 32 mm compared to the passive group with 307 ± 57 mm (p = 0.019). There were no differences (p = 0.461) in terms of illuminance between groups. A weak correlation was found between the spherical equivalent and digital habits. In a second study, the accuracy of the illuminance measurements taken by the device's light sensor was analyzed and an original method of facial illuminance measurement was studied. The results showed that the light sensor responds in a very linear way to illuminance variation (R2 > 0.98) although it overestimates or underestimates the luminance values depending on the type of light source. For a typical indoor light source, the illuminance measurement was 25% below the actual value. The proposed method allows a measurement of facial illumination with a mean error of 27%. In a third study, several experiments were carried out in order to find out if it is possible to accurately measure VA with a smartphone and a mobile application (app) that uses white or blue light stimuli. Regarding the use of white light, a difference of 0.01 logMAR (p > 0.47) was found between the VA measurement with a smartphone and the clinical measurement. Regarding the use of blue light, after determining a mean value of -0.67 ± 0.21 D for the longitudinal chromatic aberration between blue and white pixels of OLED screens of a smartphone, 90% of the subjects had a VA value that was 0.15 logMAR greater for white light than blue light. Finally, in a fourth study, far point (FP) measurements were taken with an app using blue light in subjects who had various amounts of induced myopia. The results showed a good correlation between induced myopia and that obtained from the FP measured with the app (R2 = 0.80). The mean difference between the two methods was 0.46 ± 0.23 D. Near point (NP) measurements were also taken in presbyopes, by inducing a certain addition in the subjects, and a good correlation was found between the induced addition and that obtained from the measured NP with the app (R2 = 0.81). The mean difference between both methods was 0.03 ± 0.40 D. The main conclusions of the work are that with current smartphones it is possible to measure: digital habits and modify at least the distance of use of the smartphone; facial illuminance within the accuracy limits of the device sensor; VA, although the VA in blue is slightly lower than that obtained clinically; the position of the far and near point with relatively accuracy.