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Tele-optometry: Remote Eye-care in a Post Pandemic World

by | Jan 1, 2024 | Manuscripts | 0 comments

Indira Rengarajan, M.Optom, FLVC

Occupational Optometrist, Occupational Optometry Services, Sankara Nethralaya, Chennai, India

 

Keywords: Pandemic, Tele Optometry, Telerehabilitation

Introduction:

Telemedicine is described as the use of digital technology and information sharing to deliver remote health care. With recent advancements, it is now possible for ophthalmologists to screen and treat emergency and even chronic ocular conditions to an extent with adequate assistance along with the technology. (1,2)

Tele-optometry’s major goal is to provide quality eye health to people in remote places at the appropriate time, thereby reducing the number of patients suffering from preventable or vision-threatening disorders.

How is it achieved?

The majority of teleophthalmology services rely on digital images captured by primary care physicians or trained technicians using different in-clinic technologies for anterior segment and fundus imaging. The photos are digitally transferred to an ophthalmologist for immediate or delayed evaluation.

Role of Optometrist in Tele optometry:

Optometrists’ expertise can be used efficiently and safely in collaboration with ophthalmologists to review glaucoma referrals at the community level via telehealth in the form of co-management. The ophthalmologists devised and the optometrist carried out co-management programs will be helpful for the population who can’t access eye care services. (3)

Need for Tele optometry:

Visual impairment and blindness are emerging as serious public health concerns, which can be prevented with appropriate screening and management through appropriate referral. A lack of awareness, accessibility, and affordability is the root reason for these unmet visual demands, especially in remote areas.  Teleophthalmology applications include triage, screening, consultation, remote supervision, and educational purposes. (1,3)

Scope of Tele optometry:

Tele optometry plays an effective role in a wide range of areas of optometry including geriatric eye care, paediatric eye care, binocular vision, contact lenses, and rehabilitation. For the paediatric population, teleophthalmology services include both early intervention for retinopathy of prematurity and screening. Screening and referral for conditions that can lead to blindness, such as glaucoma, age-related macular degeneration, and diabetic retinopathy, can be performed for the geriatric population. (4)

Telerehabilitation:

In April 2020, the idea of telerehabilitation was introduced as an additional component in response to the growing need to give the most vulnerable patients the finest, safest care possible. Online video consultation and training can be given for people with low vision and children with special needs in all possible areas such as vision skills training, physiotherapy, occupational therapy, speech therapy, computer training through assistive technologies, and psychological counselling. (5)

Another study has concluded that telerehabilitation approaches, in addition to traditional modes of intervention, have a considerable potential to address difficulties associated with access to multidisciplinary care in India for special cases. (6)

Innovations and Tele optometry

Telehealth and Artificial Intelligence (AI) offer synchronised solutions to the difficulties that ophthalmologists and healthcare professionals face around the world. Advancements in AI, machine learning, and home monitoring devices for progressive conditions like glaucoma serve as the biggest advantage in the successful delivery of tele-eye care in unobserved areas. (7)

Conclusion:

Tele optometry in association with advancements in innovations plays a pivotal role in increasing the reach of eye care in remote areas thereby increasing the screening rate and preventing avoidable blindness.

 

References:

  1. Sommer, A. C., & Blumenthal, E. Z. (2020). Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak. Graefe’s Archive for Clinical and Experimental Ophthalmology, 258, 2341-2352.
  2. Sharma, M., Jain, N., Ranganathan, S., Sharma, N., Honavar, S. G., Sharma, N., & Sachdev, M. S. (2020). Tele-ophthalmology: Need of the hour. Indian journal of ophthalmology, 68(7), 1328–1338. https://doi.org/10.4103/ijo.IJO_1784_20
  3. Massie, J., Block, S. S., & Morjaria, P. (2022). The role of optometry in the delivery of eye care via telehealth: a systematic literature review. Telemedicine and e-Health, 28(12), 1753-1763.
  4. Sreelatha, O. K., & Ramesh, S. V. (2016). Teleophthalmology: improving patient outcomes? Clinical ophthalmology, 285-295.
  5. Christy, B., Mahalakshmi, M., Aishwarya, T. V., Jayaraman, D., Das, A. V., & Rani, P. K. (2022). Tele-rehabilitation for persons with vision impairment during COVID-19: Experiences and lessons learned. Indian journal of ophthalmology, 70(3), 1026–1029. https://doi.org/10.4103/ijo.IJO_1722_21
  6. Philip, J., Hussaindeen, J. R., Jacob, N., Sethuraman, S., & Swaminathan, M. (2023). Parental perception of facilitators and barriers to activity and participation in an integrated tele-rehabilitation model for children with cerebral visual impairment in South India – A virtual focus group discussion study. Indian journal of ophthalmology, 71(2), 601–607. https://doi.org/10.4103/ijo.IJO_1670_22
  7. Li, J. P. O., Liu, H., Ting, D. S., Jeon, S., Chan, R. P., Kim, J. E., … & Ting, D. S. (2021). Digital technology, tele-medicine and artificial intelligence in ophthalmology: A global perspective. Progress in retinal and eye research, 82, 100900.

 

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