Swathi Madhavan , M.Optom

Assistant Professor, Hindustan Institute of Technology and Sciences, Chennai, India


In an era where technology fills every aspect of our lives, from shopping to socialising, it is no surprise that healthcare is also riding the digital wave. The virtual realm is reshaping medical services, and one such frontier experiencing this transformation is eye care. Enter Virtual Eye Assessment, a novel approach that sparks a pivotal question: Should we readily embrace this integration of technology into ocular health, or does it harvest considerations that warrant a more cautious stance?

Understanding the Need

Undeniably, traditional eye care faces challenges, from the strain on emergency departments to the substantial number of yearly visits handled by practitioners. (1, 2) The sheer volume poses a significant challenge, Eye care demand ≠  Available resources. Virtual assessments address these challenges, allowing for remote diagnosis and assessment. Telehealth, a concept dating years back, has seen slow but steady adoption. With the catalyst, COVID-19, a dramatic shift in the practice of telehealth, including ophthalmology is evident. (3)

Advancements so far

Let’s look at the evidence supporting the integration of Virtual Eye Assessment.

  1. A cloud-based referral system in the UK proved effective in avoiding over half of the referrals for potential retinal issues by having an ophthalmologist review fundus photographs. (4)
  2. Digital slit lamp videos and real-time video streaming assessments demonstrated high sensitivity and perfect agreement in identifying conditions such as strabismus and retinopathy of prematurity. (5)
  3. An Eye Care Integration Project showcased the success of an integrated electronic referral system. It resulted in a significant reduction in unnecessary referrals and notable improvements in waiting times, highlighting the benefits of a well-organised virtual system. (6)

Addressing Concerns

While the benefits are evident, concerns surrounding the safety persist. Studies have reported delayed treatment due to misdiagnosis. (7) Accessibility is another critical factor. Digital divide impedes access to telehealth services. (8) While a substantial number of adults own digital devices, the availability of home broadband remains uneven, affecting older adults, rural residents, and those with lower socioeconomic status. Bridging this gap is essential to ensure equitable access to Virtual Eye Assessment.

Balancing the Scales

As we look ahead to the future of eye care, we find ourselves at a crucial juncture. Will virtual healthcare continue to be accessible with fair coverage and payment policies? What is the best choice for patients – sticking to traditional in-person visits or embracing telehealth?

These questions are not just for healthcare professionals to ponder. They involve a mix of decision-makers – policymakers, regulators, providers, patients, and payers. Essentially, we are at the intersection of advancing technology and the core of patient-focused care. In conclusion, the era of Virtual Eye Assessment is undeniably upon us, backed by growing evidence supporting its efficacy across various domains.

While challenges and concerns persist, technology’s relentless march forward and Virtual Eye Assessment foreshadow its lasting impact. It is not a matter of ‘yes’ or ‘no,’ but rather a journey of refinement and adaptation, ensuring that as we embrace the virtual frontier, we do so with a commitment to accessibility, well-organised system, safety, and the highest standards of patient care.



  1. Rathi S, Tsui E, Mehta N, Zahid S, Schuman JS. The current state of teleophthalmology in the United States. Ophthalmology. 2017 Dec 1;124(12):1729-34.
  2. Care EE. The Way Forward.
  3. Ko MW, Busis NA. Tele–neuro-ophthalmology: vision for 20/20 and beyond. Journal of neuro-ophthalmology. 2020 Sep 1.
  4. Kern C, Fu DJ, Kortuem K, Huemer J, Barker D, Davis A, Balaskas K, Keane PA, McKinnon T, Sim DA. Implementation of a cloud-based referral platform in ophthalmology: making telemedicine services a reality in eye care. British Journal of Ophthalmology. 2020 Mar 1;104(3):312-7.
  5. Mulchandani D, Reiser BJ, Ho TC, Reid MW, Stewart C, Lee TC, Nallasamy S. Evaluation of digital slit-lamp videos for paediatric anterior segment telemedicine consultations. Journal of Telemedicine and Telecare. 2023 Jul;29(6):467-73.
  6. Khan AA, Mustafa MZ, Sanders R. Improving patient access to prevent sight loss: ophthalmic electronic referrals and communication (Scotland). Public Health. 2015 Feb 1;129(2):117-23.
  7. Bourdon H, Jaillant R, Ballino A, El Kaim P, Debillon L, Bodin S, N’Kosi L. Teleconsultation in primary ophthalmic emergencies during the COVID-19 lockdown in Paris: experience with 500 patients in March and April 2020. Journal francais d’ophtalmologie. 2020 Sep 1;43(7):577-85.
  8. Mobile Fact Sheet – https://www.pewresearch.org/internet/fact-sheet/mobile/ (Accessed on 25th January 2024)