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ORIGINAL RESEARCH article

Front. Bioeng. Biotechnol.

Sec. Biosensors and Biomolecular Electronics

Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1678800

Innovative myopic screening platform based on smartphones

Provisionally accepted
Qiang  SuQiang Su1Yicheng  GeYicheng Ge2Jinghui  WangJinghui Wang1Nan  JinNan Jin1Haochen  HanHaochen Han1Yingxin  LiYingxin Li3Chea Su  KeeChea Su Kee4Bei  DuBei Du1*Ruihua  WeiRuihua Wei1*
  • 1Tianjin Medical University Eye Hospital, Tianjin, China
  • 2Department of Ophthalmology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
  • 3Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
  • 4The Hong Kong Polytechnic University, Hong Kong, Hong Kong, SAR China

The final, formatted version of the article will be published soon.

Introduction: To validate a novel smartphone-based approach for subjective refraction, specifically for myopia screening, offering a cost-effective and accessible tool for at-home vision assessment. Methods: A total of 230 healthy volunteers, encompassing 460 eyes, aged between 7 and 40 years (mean±SD: 21.04±7.76), and exhibiting refractive error (RE) ranging from -6.25 to +0.50 diopter (D), were deemed eligible subjects in this research. Subjective refraction assessments were conducted on all subjects, involving both the conventional phoropter examination by experienced optometrists which served as the clinical gold-standard, and the smartphone-based methodology. During smartphone measurement, the screen was gradually moved toward the eye until achieving clear differentiation of the 'E' optotypes and the astigmatic dial. The eye-to-smartphone screen distances (ESD) were calculated based on the image of iris diameter (ID) acquired by the front-facing camera of the smartphone. Applying the definitions of the far point and the rule of thirty, this allowed for the computation of sphere (S), cylinder (C), and astigmatism axis (α) values. The concordance between the two methods was assessed by establishing the Limits of Agreement (LOAs), which were calculated as the mean difference ± 1.96 times the standard deviation of the differences. Results: The smartphone‑based screening technique showed that it closely matched the gold-standard subjective refraction used in clinical practice. The LOAs for S, C, and spherical equivalent refraction (SER) were 0.11±0.89 D, -0.03±0.82 D, and 0.10±0.89 D, respectively. The average deviation in measuring the α was 4.72°, with 64.35% of deviations falling within the ±15° range. Additionally, the technique demonstrated impressive areas under the receiver operating characteristic curve (AUC) of 0.973 for the range of -3.00 D < SER ≤ 0.00 D and 0.986 for the range of - 6.00 D < SER ≤ -3.00 D. Discussion: The innovative vision screening through smartphones can expand access to measuring RE, especially in home. The study confirms the validity of an innovative vision-screening approach for myopia. Its effectiveness and accessibility make it a valuable tool for opportunistic or large-scale myopia screening programs.

Keywords: Myopia, Vision Screening, Subjective refraction, Far point, Smartphone measurement

Received: 03 Aug 2025; Accepted: 30 Sep 2025.

Copyright: © 2025 Su, Ge, Wang, Jin, Han, Li, Kee, Du and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Bei Du, dubei1982@126.com
Ruihua Wei, rwei@tmu.edu.cn

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