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Tele-optometry: Is it the future of clinical practice in Optometry in the era of Pandemic COVID 19?

by | Dec 1, 2021 | Manuscripts | 0 comments

Prateeksha G Hegde, Bachelor of Optometry

Intern Optometrist, Sankara College of Optometry, Sankara Eye Hospital, Bengaluru, India

 

Figure 1: Fundus photograph was taken with smartphone ophthalmoscope at a diabetic retinopathy screening camp in the rural area of Karnataka, India

 

Introduction:

Tele-optometry refers to an assessment of a patient’s ocular health in the absence of a clinician physically in the location. Prefix Tele is derived from Greek which means “at a distance”. (1) With the help of assistive devices such as smartphones, advanced hardware and software combination and remote video tool technology conjoined with artificial intelligence.

Objectives:

The main objective of tele-optometry is to provide quality eye health care to patients who are in remote areas at the appropriate time. The main goal of tele-optometry is to reduce the number of patients suffering from preventable or vision-threatening diseases.

Discussion:

Especially in the current pandemic situation people in the rural areas are deprived of early detection of ocular diseases such as cataract, glaucoma, diabetic and hypertensive retinopathy, amblyopia, or any ocular emergencies, etc., (2) which leads to irreversible ocular damage. (1) Whereas early or timely detection of pathological changes could save vision. Immediate lockdown to control COVID-19 spread led to the unwillingness of the patient to visit the eye hospital, which resulted in reduced outpatient activity (3). In that scenario, tele-optometry has come into the limelight helping many patients to improve their quality of vision or to retain their residual vision. Among multiple types of equipment, one of the good examples of a screening tool could be Fundus photo with smartphone ophthalmoscope (Paxoscope). It helps in visualizing retinal vasculature, background retina, optic disc, and macula, which helps in early detection of conditions like glaucoma, diabetic or hypertensive retinopathy, cystoid macular oedema, etc., in turn, helps for early intervention even in this pandemic era at remote or rural areas. (4)

Even though the concept of tele-optometry is not very new, current COVID 19 pandemic conditions have forced us to adapt and develop tele-optometry so that in the conditions like any ocular emergencies, patients are referred at the proper time and get proper management accordingly. Many platforms like video consultations are making our life better and getting less vulnerable even in the condition of lockdown.

Along with numerous advantages, Tele-optometry has got few limitations also. The major drawback being many consultants are not trained for teleconsultation. Hence extensive training is required for the same. One more challenge is management and follow-up with the patient once the condition is diagnosed. Since it is in the developmental stage, standardized teleconsultation charge needs to be fixed which remains the same and uniform from place to place and from consulting to a consultant. (5)

The current scenario has forced all of us to become tech-savvy and made our lives easier and approachable anytime to all outpatients.  The tele-optometry is the future of eye care service, not only for providing a better quality of vision in a pandemic but also for screening, early diagnosis, intervention, and management plans in remote or rural areas. As the COVID-19 pandemic is still spreading its wing, it’s necessary to adapt and adjust ourselves to the newer technologies and to get the best benefit out of it.

 

References:

  1. Nikolaidou A, Tsaousis KT. Teleophthalmology and Artificial Intelligence As Game Changers in Ophthalmic Care After the COVID-19 Pandemic. Cureus. 2021 Jul;13(7).
  2. Sommer AC, Blumenthal EZ. Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2020 Aug 19:1-2
  3. Prathiba V, Rema M. Teleophthalmology: a model for eye care delivery in rural and underserved areas of India. International journal of family medicine. 2011;2011.
  4. Iqbal U. Smartphone fundus photography: a narrative review. International Journal of Retina and Vitreous. 2021 Dec;7(1):1-2.
  5. Wedekind L, Sainani K, Pershing S. Supply, and perceived demand for teleophthalmology in triage and consultations in California emergency departments. JAMA ophthalmology. 2016 May 1;134(5):537-43.

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