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Peer-reviewedCC BYPLOS One

Patient preferences for portable versus table-mounted visual field devices in rural Alabama: A mixed methods study within a telemedicine setting

  • Ellen K Antwi-Adjei1,2
  • Sourav Datta1
  • Christopher A Girkin3
  • Cynthia Owsley2
  • Lindsay A Rhodes2
  • Matthew Fifolt4
  • Lyne Racette2
4 affiliations
  1. 1Vision Science Graduate Program, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
  2. 2Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
  3. 3Viterbi Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, California, United States of America.
  4. 4Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
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Abstract

Purpose: To evaluate patient satisfaction and preferences for portable versus table-mounted visual field (VF) devices in a rural telemedicine setting and identify influencing factors. Methods: We conducted a sequential explanatory mixed methods study at three Federally Qualified Health Centers (FQHCs) within the Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine (AL-SIGHT) study. Participants completed VF testing with table-mounted Humphrey Field Analyzer (HFA), tablet-based Melbourne Rapid Fields (MRF), and virtual reality (VR)-based VisuALL perimeters. Participants rated satisfaction, comfort, ease of use, and future testing preference. Chi-square tests assessed differences in device preferences. Twelve participants completed semi-structured interviews to explore reasons underlying preferences. Qualitative data were analyzed in NVivo 14 using reflexive thematic analysis. Results: Among 271 respondents (mean age 60.4 years; 62.4% women), 50.6% preferred VR-based, 35.1% tablet-based, and 14.4% table-mounted for future testing (χ2 (2) = 53.52, p < 0.001, Cramér’s V = 0.31). Satisfaction was highest for VR-based (56.9% very satisfied), followed by tablet-based (49.4%), and HFA (38.0%). VR-based perimeter was most frequently selected as the most comfortable (55.7%; χ2 (2) = 63.33, p < 0.001, V = 0.34) and easiest to use (54.6%; χ2 (2) = 71.96, p < 0.001, V = 0.36). Preferences did not vary significantly across demographic variables (all p > 0.05). Qualitative themes identified four key drivers: comfort and physical experience, visual experience, ease of use and interaction, and psychological and motivational factors. Portability and community suitability were valued. Conclusion: Rural underserved patients strongly preferred portable visual field devices, particularly VR-based, over table-mounted HFA. Comfort, ergonomic flexibility, immersive visual experience, and simplicity of interaction were central determinants of preference. Portable perimetry may enhance patient-centered glaucoma monitoring within telemedicine programs and access in resource-limited settings.

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Cite

BibTeXRIS
BibTeX
@article{antwiadjei2026patient,
  title = {{Patient preferences for portable versus table-mounted visual field devices in rural Alabama: A mixed methods study within a telemedicine setting}},
  author = {Ellen K Antwi-Adjei and Sourav Datta and Christopher A Girkin and Cynthia Owsley and Lindsay A Rhodes and Matthew Fifolt and Lyne Racette},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0348821},
  url = {https://doi.org/10.1371/journal.pone.0348821},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Patient preferences for portable versus table-mounted visual field devices in rural Alabama: A mixed methods study within a telemedicine setting
AU  - Ellen K Antwi-Adjei
AU  - Sourav Datta
AU  - Christopher A Girkin
AU  - Cynthia Owsley
AU  - Lindsay A Rhodes
AU  - Matthew Fifolt
AU  - Lyne Racette
PY  - 2026
DA  - 2026/10/26
JO  - PLOS One
DO  - 10.1371/journal.pone.0348821
UR  - https://doi.org/10.1371/journal.pone.0348821
AB  - Purpose: To evaluate patient satisfaction and preferences for portable versus table-mounted visual field (VF) devices in a rural telemedicine setting and identify influencing factors. Methods: We conducted a sequential explanatory mixed methods study at three Federally Qualified Health Centers (FQHCs) within the Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine (AL-SIGHT) study. Participants completed VF testing with table-mounted Humphrey Field Analyzer (HFA), tablet-based Melbourne Rapid Fields (MRF), and virtual reality (VR)-based VisuALL perimeters. Participants rated satisfaction, comfort, ease of use, and future testing preference. Chi-square tests assessed differences in device preferences. Twelve participants completed semi-structured interviews to explore reasons underlying preferences. Qualitative data were analyzed in NVivo 14 using reflexive thematic analysis. Results: Among 271 respondents (mean age 60.4 years; 62.4% women), 50.6% preferred VR-based, 35.1% tablet-based, and 14.4% table-mounted for future testing (χ2 (2) = 53.52, p < 0.001, Cramér’s V = 0.31). Satisfaction was highest for VR-based (56.9% very satisfied), followed by tablet-based (49.4%), and HFA (38.0%). VR-based perimeter was most frequently selected as the most comfortable (55.7%; χ2 (2) = 63.33, p < 0.001, V = 0.34) and easiest to use (54.6%; χ2 (2) = 71.96, p < 0.001, V = 0.36). Preferences did not vary significantly across demographic variables (all p > 0.05). Qualitative themes identified four key drivers: comfort and physical experience, visual experience, ease of use and interaction, and psychological and motivational factors. Portability and community suitability were valued. Conclusion: Rural underserved patients strongly preferred portable visual field devices, particularly VR-based, over table-mounted HFA. Comfort, ergonomic flexibility, immersive visual experience, and simplicity of interaction were central determinants of preference. Portable perimetry may enhance patient-centered glaucoma monitoring within telemedicine programs and access in resource-limited settings.
SN  - 1932-6203
ER  -