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Teleophthalmology - The Future of Eye Care

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Teleophthalmology is an evolving clinical tool that makes eye care accessible to remote areas. Read the article to know more.

Medically reviewed by

Dr. Shikha Gupta

Published At June 9, 2023
Reviewed AtJune 9, 2023

Introduction

Teleophthalmology combines medical technology and electronic information via digital medical devices and telecommunication. Teleophthalmology is a new clinical field in the healthcare system that allows doctors to give high-quality care. It aids in improving medical care access, treatment outcomes, and patient satisfaction. It transports health care to rural locations, making it easily available to those who live there. Teleophthalmology is used to do eye screenings in the community.

This can bring the medical facility directly to the patient's place and help the doctors to diagnose serious eye conditions such as diabetic retinopathy, glaucoma, cataract, and macular degeneration. This prompt diagnosis can help timely treatment of the conditions. On-site diagnosis often needs smaller appliances such as a non-cataract tonometer, automated refractor, non-mydriatic retinal camera, and optical coherence tomography.

The screening is carried out by an opthalmologist who prepares an assessment and treatment plan for the individual. Teleophthalmology helps provide health services related to the eyes of the rural population. It helps improve eye care and the timely diagnosis of certain severe eye conditions, thus enhancing the quality of life of individuals with eye problems.

What Is the Process of Teleophthalmology?

Teleophthalmology is carried out in two ways:

1. Synchronous Teleophthalmology - In synchronous teleophthalmology, there is an interaction between ophthalmologists and patients via telecommunication. This can be used for teleconsultations between two or more ophthalmologists or between an individual and an opthalmologist. Synchronous teleophthalmology can be used to supervise the removal of foreign bodies from the cornea with the help of video-conferencing

2. Asynchronous Teleophthalmology - In asynchronous teleophthalmology, the diagnosis and other data are stored and evaluated by the doctors later.

How Is the Screening Carried Out in Teleopthalmology?

A Detailed Patient History: A patient's history is taken before the process of teleophthalmology with the help of a standard history form. The history includes age, gender, ethnicity, medications, and medical history. Other specific history is collected if the eye screening is carried out as a part of other health screening tests. A thorough family history is taken for conditions like blood pressure, diabetes, heart diseases, and other eye conditions.

Visual Acuity Test: Visual acuity is the eye's ability to differentiate between shapes and various objects at a certain distance. It is accessed in a consistent way to detect any vision changes. It is measured with the help of a standard Snellen chart. The individual is made to sit 20 feet away and made to read the eye chart. This is a standard method of eye screening that help in identifying people with blurred vision. This data is then used to identify the cause of blurred vision.

Automated Refractor: The automated refractor measures the correction required to focus the person's eyes on an image at a distance. They are important in measuring the eye's refractive state in cylinder, sphere, and axis. The measurements are then transferred into a prescription for eyeglasses. Automated refractors provide an estimated refractive error of the eyes, which correlates with the correct refractive error. They are preferred when there is an issue with communication due to a language barrier, with kids, or with disabled people.

Non-contact Tonometry: Non-contact tonometry is a non-invasive measurement of intraocular pressure. These instruments do not require anesthetic eye drops. This helps to deal with less cooperative patients, such as kids and people with disabilities. This test helps screen eye diseases like glaucoma, one of the leading causes of blindness. Non-contact tonometry may not give some individuals a correct estimation of the intraocular pressure and should be re-evaluated for confirmation.

Fundus Photography: Fundus photography is the process of taking an image of the retina with the help of a fundus camera. It is essential for diagnosing and treating various eye diseases. Cameras such as digital non-mydriatic retinal cameras take a picture of the retina, its vasculature, optic disc, and the macula. It helps diagnose conditions like diabetic retinopathy, glaucoma, hypertensive retinopathy, and age-related eye changes.

Low light conditions induce dilation of the pupil without dilating eye drops. This makes fundus photography an accessible tool. Fundus autofluorescence is also used in screening programs. These retinal cameras are easy to use and carry. Fundus autofluorescence evaluates certain eye diseases more correctly as compared to fundus photography.

Optical Coherence Tomography: Optical coherence tomography is a technology for performing high-technology imaging. It is a non-invasive method of creating pictures of the back of the eye with the help of reflected light. It is used in eye screening for age-related eye changes, glaucoma, and diabetic retinopathy.

What Are the Benefits of Teleophthalmology?

There are numerous benefits of teleophthalmology. They are as follows:

  • Teleophthalmology makes eye care services feasible for a wider population.

  • Consultations are done online with the help of telecommunication, thus strengthening the referral patterns.

  • Eye care services can be taken to remote areas with limited healthcare access.

  • Teleophthalmology can be used to educate clinical personnel on various methodologies.

  • It is a cost-effective screening method.

  • Doctors can also interact with each other over video conferencing to discuss certain cases.

  • Inexperienced ophthalmologists can increase their knowledge by several attending video conferences.

  • Teleophthalmology is important in emergencies for diagnosis and treatment in rural areas.

What Are the Challenges of Teleophthalmology?

Teleophthalmology has its share of challenges. They are as follows:

  • Patient retention.

  • Keeping follow-up appointments.

  • Regulatory challenges.

  • Reimbursement of teleophthalmology services.

Conclusion

Teleophthalmology has been present for many years. Telemedicine has many advantages, like taking eye health care to remote and inaccessible areas. However, many challenges are faced by doctors and patients who have yet to allow the use of this technology. User-friendly platforms can be created to overcome such barriers. The use of telemedicine and teleophthalmology has increased manifold since the pandemic. It is a cost-effective, accurate, and trustworthy screening modality. Early detection of certain serious eye conditions, especially in places with inaccessible healthcare systems. The development of telemedicine in the past few years has paved the way for many new screening methods for retinopathy. Teleophthalmology imaging techniques have evolved over a few decades and revolutionized the health care system.

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Dr. Shikha Gupta
Dr. Shikha Gupta

Ophthalmology (Eye Care)

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eye careteleophthalmology
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