A Novel Tele-Eye Protocol for Ocular Disease Detection and Access to Eye Care Services

Abstract Background: Telemedicine can improve access to care, especially for rural patients, and ophthalmology is a field that lends itself readily to telemedicine because interpretation of photographs is a routine part of diagnosing eye disease and patient care. We developed a novel tele-eye protocol based on diabetic teleretinal screening. We performed a feasibility study to see if our tele-eye program was comparable to the gold standard face-to-face eye exam. Materials and Methods: Fifty-two subjects underwent the tele-eye protocol and then received a face-to-face exam. A masked reader reviewed the tele-eye data remotely and developed an impression and plan for the patient. The provider assessments from the face-to-face exams and the tele-eye exams were compared. Sensitivity, specificity, and percentage agreement were calculated for the tele-eye protocol, focusing on the most common age-related eye diseases: cataract, macular degeneration, and glaucoma. The difference between the autorefraction and man...

[1]  N Blackwell,et al.  The use of telemedicine to treat ophthalmological emergencies in rural Australia , 1998, Journal of telemedicine and telecare.

[2]  Cynthia Owsley,et al.  Vision Impairment and Eye Care Utilization among Americans 50 and Older , 2010, Current eye research.

[3]  Robert W. Massof,et al.  Racial variations in causes of vision loss in nursing homes: The Salisbury Eye Evaluation in Nursing Home Groups (SEEING) Study. , 2004, Archives of ophthalmology.

[4]  A. Juutinen,et al.  The application of teleophthalmology in examining patients with glaucoma: a pilot study. , 1999, Journal of glaucoma.

[5]  Joseph W Eichenbaum,et al.  Geriatric vision loss due to cataracts, macular degeneration, and glaucoma. , 2012, The Mount Sinai journal of medicine, New York.

[6]  R A Tang,et al.  Telemedicine screening of glaucoma. , 1999, Telemedicine journal : the official journal of the American Telemedicine Association.

[7]  E. Keeler,et al.  Treatment of Uncorrected Refractive Error Improves Vision‐Specific Quality of Life , 2006, Journal of the American Geriatrics Society.

[8]  R. Klein,et al.  Performance-based and self-assessed measures of visual function as related to history of falls, hip fractures, and measured gait time. The Beaver Dam Eye Study. , 1998, Ophthalmology.

[9]  R. Klein,et al.  Causes and prevalence of visual impairment among adults in the United States. , 2004, Archives of ophthalmology.

[10]  Working toward a portable tele-ophthalmic system for use in maximum-security prisons: a pilot study. , 2001, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[11]  Marie Carole Boucher,et al.  Teleophthalmology screening for diabetic retinopathy through mobile imaging units within Canada. , 2008, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[12]  S. Cummings,et al.  Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. , 1995, The New England journal of medicine.

[13]  Jennifer K. Sun,et al.  Visual acuity testing using autorefraction or pinhole occluder compared with a manual protocol refraction in individuals with diabetes. , 2011, Ophthalmology.

[14]  Der-Ming Liou,et al.  Feasibility of tele-ophthalmology for screening for eye disease in remote communities , 2004, Journal of telemedicine and telecare.

[15]  April Y. Maa,et al.  Veteran eye disease after eligibility reform: prevalence and characteristics. , 2013, Military medicine.

[16]  C. Rudnisky,et al.  The prevalence of diabetic retinopathy as identified by teleophthalmology in rural Alberta. , 2010, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[17]  N. Congdon,et al.  Prevalence of cataract and pseudophakia/aphakia among adults in the United States. , 2004, Archives of ophthalmology.

[18]  R. Klein,et al.  The economic burden of major adult visual disorders in the United States. , 2006, Archives of ophthalmology.

[19]  Mancho Ng,et al.  Improving Access to Eye Care: Teleophthalmology in Alberta, Canada , 2009, Journal of diabetes science and technology.