Usefulness of a simplified self-checking tool (Quattro Checker®) for visual field defects in glaucoma patients

PURPOSE: To develop and evaluate iPad Quattro Checker® (iPad QC®), a tablet-based screening tool for detecting glaucomatous visual field (VF) abnormalities. METHODS: We evaluated three screening methods-the iPad QC®, paper-based Quattro Checker® (paper QC®), and CLOCK CHART®-in glaucoma patients across disease stages (n = 64) and in normal participants (n = 38). VF abnormalities were defined in relation to corresponding quadrants of the Humphrey Field Analyzer (HFA). Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC) were calculated. RESULTS: Among all patients, the AUCs of the iPad QC®, paper QC®, and CLOCK CHART® were 0.97, 0.94, and 0.96, respectively. The iPad QC® retained 80.2% sensitivity in early glaucoma, with an AUC of 0.90 (95% CI: 0.81-0.98). More than half of previously unaware patients recognized their VF deficits using the iPad QC®. Testing required only a few minutes, could be self-administered on a widely available tablet, and was performed under ordinary room lighting. CONCLUSION: The iPad QC® demonstrated high sensitivity for detecting visual field abnormalities even in the early stages of glaucoma. Its capability for self-testing using widely available tablet devices, along with its ability to raise patients' awareness of VF defects, further enhances its usefulness as a practical screening tool.