Gaming to improve vision: 21st century self-monitoring for patients with age-related macular degeneration

Importance: Improved vision self-monitoring tools are required for people at risk of neovascular complications from age related macular degeneration (AMD). Background: to report the self-monitoring habits of participants with intermediate AMD using the Amsler grid chart, and the use of personal electronic devices and gameplay in this over 50 year old cohort. Design: single-centre descriptive study carried out at the Centre for Eye Research (CERA), Melbourne, Australia. Participants: 140 participants over 50 years of age, with a diagnosis of intermediate AMD and best-corrected visual acuity (BCVA) of ≥6/12 in each eye. Methods: structured questionnaire survey of participants who were enrolled in natural history of AMD studies at CERA. Main outcome measures: frequency of vision self-monitoring using the Amsler grid chart, and frequency of general use of personal electronic devices and gameplay. Results: Of 140 participants with mean age of 70.5 years, 83.6% used an Amsler grid chart, but only 39.3% used it once per week. Most participants (91.4%) used one or more personal electronic devices. Of these, over half (54.7%) played games on them, among whom 39% played games once a day. Of participants aged 50–69 years, 92% (95%CI 85.1–98.9) were willing to play a game to monitor their vision, compared to 78% (95%CI 69.0–87.0) of those aged 70 years and older (P < 0.05). Conclusions and Relevance: a large proportion of AMD patients already use personal electronic devices. Gamification techniques are likely to increase compliance with self-monitoring, leading to earlier detection in the next generation of patients with neovascular AMD.