Developed by Apptitude in collaboration with Veranex, this platform is part of an innovative public health approach. It aims to democratise the screening of vision disorders and reduce the burden of undetected conditions, particularly among ageing populations or those living far from medical centres.
Key takeaways from this digital medical screening platform
- A free, simple, fast and accessible eye test for all
- No intrusive data collection
- A filtering tool that reassures or identifies urgent cases and encourages medical consultation
- An awareness tool that complements traditional prevention methods
- A reliable self-assessment tool, developed with medical and technological rigour
- A CE-certified platform, compliant with EN ISO 13485:2016, EN ISO 14971:2019, EN 62304:2006/A1:2015
- Over 2,000 tests performed every month
The free, accessible and certified online eye test
The test allows users to quickly assess the quality of their vision. The platform, compatible with major browsers (Chrome, Safari, Firefox, Edge), does not provide a medical diagnosis, but raises awareness about the importance of screening and encourages users to consult professionals if in doubt.
Visual health is a growing concern
The ageing population is increasing the prevalence of visual impairments. The Øjenforeningen association highlights the need for regular screening, ideally on a yearly basis. Data shows that:
- Most visual impairments occur after the age of 61
- These issues become particularly disabling after the age of 71
Preventing these impairments involves raising awareness, guiding people towards professionals (opticians, ophthalmologists), and promoting early screening. Eye-sight.org fits perfectly into this strategy by facilitating access to an initial check-up.
The challenge of transforming a physical service into a digital one: “do it yourself” at the heart of healthcare
The digitalisation of the medical sector, or medtech, is a well-known current trend. Eye-sight.org illustrates this shift by transforming a traditional in-practice test into a digital self-test. This brings many advantages:
- 24/7 access without geographical or scheduling constraints
- Autonomy for the user, who can perform an initial check themselves
- Acts as a “first filter”, helping to guide quickly towards a consultation if needed, or to reassure in cases of normal vision
Online eye tests are very useful for detecting common visual impairments (myopia, hyperopia, astigmatism, etc.) and referring users to a consultation when necessary. Their value is indicative: they do not replace an examination carried out by an optician or ophthalmologist, but they can be reliable tools if properly developed, carefully used (as we will see below), and interpreted with caution (which is entirely up to the user).
Barriers to visual consultations… and the role of self-tests
Several factors hinder the early management of visual disorders. The aim of this solution is to provide a general and acceptable response to:
- Demographic ageing and the rise of chronic diseases, which increase demand and therefore the workload of clinics
- A shortage of specialists, particularly in certain regions, leading to long waiting times
- Lack of information, poor awareness of early signs, and underestimation of their seriousness
- Time constraints and social isolation
A development carried out with the full rigour of medical certification: a major challenge… down to the last pixel
The CE certification of the Eye-sight.org test, in compliance with European regulations, is based on a strict process involving Apptitude and Veranex. This collaboration ensured the platform’s safety, compliance and reliability, notably through:
- EN ISO 13485:2016, ensuring a rigorous quality management system that tracks all phases of development
- EN ISO 14971:2019, applied to identify and manage risks related to use (false negatives, misinterpretation)
- EN 62304:2006/A1:2015, governing the software life cycle, from specifications to testing and updates
The core of our challenge? In addition to offering a simple user experience, we had to ensure that the display of optotypes—the well-known symbols used to measure vision—met the strict criteria of LogMAR, the international reference for visual acuity measurement.
LogMAR and the Landolt C optotype: ensuring the reliability of an online eye test
In a certified medtech project such as Eye-sight.org, the use of LogMAR is central to ensuring the accuracy and comparability of visual acuity results. LogMAR (Logarithm of the Minimum Angle of Resolution) expresses visual acuity on a linear scale, facilitating statistical analysis and comparison across patients or populations.
Why is LogMAR used?
Unlike traditional scales (Snellen, Monoyer), the LogMAR scale ensures that each line of the test represents the same gain or loss in visual acuity. This allows for more reliable statistical analysis and better reproducibility of results.
Results are easily comparable across different tests, contexts, or populations, which is essential for an online service.
The connection with the Landolt C optotype
The C optotype, or Landolt C, is a standardised symbol used to measure visual acuity, notably in LogMAR tests. It offers several advantages, including being suitable for assessing the vision of children or people unable to read letters. It consists of a “C” with a gap open in different directions. The vision test involves determining the direction in which the gap is open: right, left, up, down, or diagonal. Using keyboard arrows to “capture and translate” the normally spoken response was therefore logical, as was abandoning the diagonal opening.
However, the size of the “C” gap (the slit) must correspond to a precise visual angle for each level of acuity tested. The progression of the optotype sizes follows the logic of LogMAR, where each level corresponds to a constant reduction or increase in the minimum angle of resolution (MAR).
The challenge of screen calibration
One of the challenges online is that the physical size of the displayed optotype depends on the size and resolution of the user’s screen. If the optotype is not displayed at the correct size, the test loses all validity.
To ensure proper display, a calibration system based on a universal and standardised object was needed. This object was identified as a plastic card in bank card format. Whether it is a credit card, identity card, or driving licence, the user simply places it against their screen. They then use a zoom function to match the size of the imprint shown on their screen to the size of their physical card. This allows us to determine the dimensions of the monitor and automatically adjust the display of the optotypes.
A physical validation was necessary, using a caliper
To ensure the accuracy of this software calibration, we conducted physical measurements of the Landolt C gap displayed on the screen, using… a certified caliper! This metrological check allowed us to verify that the “C” gap exactly met the required proportions (neither too wide nor too narrow), in accordance with international recommendations (ISO 8596), regardless of the screen used. An uncommon approach in a digital project, but essential in this medical context.
In summary
The use of LogMAR in a project like eye-sight.org ensured a regular and scientifically valid progression of the visual acuity tested. The link with the Landolt C optotype is direct: the size of the “C” gap must be precisely calibrated for each acuity level, which required a dual validation:
- Software-based (via calibration with a bank card)
- Physical (via measurement with a certified caliper)
This approach guarantees the reliability and medical validity of the online test, regardless of the screen used and the patient’s context. This is how certification was achieved.
A structured and certifiable approach and documentation
Beyond the technical innovation, the project was from the outset part of a strict quality process, aligned with medical sector standards. The software development was carried out following the V-model. This reference method for medical devices structures each phase, from requirements definition to acceptance testing. Each step is thus rigorously validated.
This model ensures:
- complete traceability of functional and regulatory requirements,
- comprehensive documentation, ready for audit or certification procedures,
- robust test coverage at all levels: unit tests, integration tests, validation, and acceptance tests.
This framework meets the requirements of the IEC 62304 standard, which governs the software life cycle of medical devices. It mandates documented practices for:
- software risk management,
- planning and maintenance,
- traceability between requirements and tests,
- risk classification (from A to C according to their severity and likelihood).
Veranex led the regulatory validation of the device, while Apptitude integrated these constraints from the very first lines of code. The result: an intuitive interface, designed with algorithms adhering to medical best practices and a software architecture perfectly aligned with safety requirements.
This quality imperative is not only about compliance: it also enables building a reliable, maintainable, and scalable product, while facilitating entry into CE certification processes in particular.
Conclusion: a digital innovation serving public health
Due to the association’s approach and the deliberate choice to collect almost no personal data, it is unfortunately not possible to draw quantitative conclusions about the impact of the test and the platform. This includes effects on appointment bookings, geographic distribution of use, or the acceptance and perception by different user types, which would have been interesting to know. The ethical framework ensures complete confidentiality but limits the possibilities for detailed analysis!
Nevertheless, we are convinced that this tool, complementary to the traditional care pathway, stands as a valuable ally with key strengths:
- Helping to quickly detect cases requiring medical attention.
- Reassuring people whose vision appears normal, thereby avoiding unnecessary medical overconsumption.
- Facilitating prevention through the democratization offered by a free, certified vision test.
This platform demonstrates how digital innovation can transform vision screening while respecting regulatory requirements and acceptability challenges. Eye-sight.org illustrates the complementarity between technology, prevention, and the classic medical pathway. It paves the way for a more accessible and efficient approach to visual health. Its use is encouraged and expected to expand well beyond Denmark. The platform is accessible in eight languages.
At Apptitude, we are proud to have supported this international initiative. Our ethics committee quickly validated this project, which carries real social and practical impact.
Your turn! Test your vision now at eye-sight.org and take care of your visual health in just a few minutes.
You’re developing a medtech solution or a digital health platform? Let’s talk compliance, certification, and impact.
At Apptitude, we support you in creating digital products designed to meet the highest medical standards (ISO 13485, MDR…), while keeping people and usability at the heart of the project. And if your project targets other highly regulated sectors like sports, industry, or energy, our team will guide you with the same rigor and creativity. Get in touch to discuss your needs!