Feasibility and performance of eye movement perimetry for glaucoma triage in Tanzania: A prospective cross-sectional study in a real-world setting
6 affiliations
- 1International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- 2School of Health and Medical Sciences, City St George’s, University of London, London, United Kingdom
- 3Institute of Ophthalmology, University College London, London, United Kingdom
- 4Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- 5Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- 6Christian Blind Mission, Bensheim, Germany
Abstract
Triaging access to glaucoma diagnostics could allow patients to receive earlier care to slow disease progression. There is a particular need in lower-resource settings where the cost and lack of portability of standard automated perimetry (SAP) restrict access. Eye movement perimetry (EMP) uses eye-tracking technology to provide a rapid assessment of the visual field using a tablet computer. A cross-sectional study in Tanzania was undertaken to assess the feasibility of EMP as an initial glaucoma triage tool. EMP hit rate correlated with SAP mean deviation in 370 eyes (Spearman’s rank correlation coefficient, ρ = 0.441, p < 0.001) and graphical comparisons indicated good localisation of defects. In emulated triage of 232 participants, EMP exhibited very high (100.0%) sensitivity (95%CI: 95.5 to 100.0%) in identifying eyes with mean deviation ≤ -6 dB), meaning that a high EMP hit rate was strong evidence of a healthy visual field. However, specificity was 20.7% (95%CI: 15.0 to 27.8%), meaning that many individuals with no severe field defect would require SAP to confirm this. Specificity was limited by EMP test failure, which occurred in 75 of 480 eyes (15.6%), as well as export or processing failure which occurred in 35 eyes (7.3%). Participants preferred EMP to SAP testing and agreed that it was easy to perform. In a real-world setting, EMP rapidly and accurately identifies patients without a significant visual field defect. However, refinement is required to reduce the high number of unnecessary referrals or false positives for EMP to prove useful as a triage tool.
Related
- Point-of-care hearing screening using consumer wireless earbuds in patients with USH2A-associated retinal disease: a prospective pilot feasibility study
- Effects of Real-Time Visual Finger-Movement Feedback on Finger Tapping Performance in Older Adults.
- Valorization of shrimp waste meal through organic acid treatment: Impact on broilers performance, serum metabolites, digestibility, meat quality, and economic feasibility.
- Association of Dysphagia and Oral Involvement with Growth and Nutritional Status in Pediatric Lipoid Proteinosis: A Prospective Cross-Sectional Study
- Serial ultrasound assessment of flexor carpi ulnaris and biceps brachii cross-sectional area in critically ill patients: A prospective cohort study
BibTeX
@article{thirunavukarasu2026feasibility,
title = {{Feasibility and performance of eye movement perimetry for glaucoma triage in Tanzania: A prospective cross-sectional study in a real-world setting}},
author = {Arun J. Thirunavukarasu and Victor H. Hu and Pete R. Jones and Elliott H. Taylor and Einoti Matayan and Sia Mbishi and Edith Macha and Tara Mtuy and David P. Crabb and William Makupa and Matthew J. Burton and Heiko Philippin},
journal = {PLOS Global Public Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pgph.0007237},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007237},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Feasibility and performance of eye movement perimetry for glaucoma triage in Tanzania: A prospective cross-sectional study in a real-world setting
AU - Arun J. Thirunavukarasu
AU - Victor H. Hu
AU - Pete R. Jones
AU - Elliott H. Taylor
AU - Einoti Matayan
AU - Sia Mbishi
AU - Edith Macha
AU - Tara Mtuy
AU - David P. Crabb
AU - William Makupa
AU - Matthew J. Burton
AU - Heiko Philippin
PY - 2026
DA - 2026/09/25
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0007237
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007237
AB - Triaging access to glaucoma diagnostics could allow patients to receive earlier care to slow disease progression. There is a particular need in lower-resource settings where the cost and lack of portability of standard automated perimetry (SAP) restrict access. Eye movement perimetry (EMP) uses eye-tracking technology to provide a rapid assessment of the visual field using a tablet computer. A cross-sectional study in Tanzania was undertaken to assess the feasibility of EMP as an initial glaucoma triage tool. EMP hit rate correlated with SAP mean deviation in 370 eyes (Spearman’s rank correlation coefficient, ρ = 0.441, p < 0.001) and graphical comparisons indicated good localisation of defects. In emulated triage of 232 participants, EMP exhibited very high (100.0%) sensitivity (95%CI: 95.5 to 100.0%) in identifying eyes with mean deviation ≤ -6 dB), meaning that a high EMP hit rate was strong evidence of a healthy visual field. However, specificity was 20.7% (95%CI: 15.0 to 27.8%), meaning that many individuals with no severe field defect would require SAP to confirm this. Specificity was limited by EMP test failure, which occurred in 75 of 480 eyes (15.6%), as well as export or processing failure which occurred in 35 eyes (7.3%). Participants preferred EMP to SAP testing and agreed that it was easy to perform. In a real-world setting, EMP rapidly and accurately identifies patients without a significant visual field defect. However, refinement is required to reduce the high number of unnecessary referrals or false positives for EMP to prove useful as a triage tool.
SN - 2767-3375
ER -