Real-time teleophthalmology in rural Western Australia.

OBJECTIVE This study aims to assess the current utilisation of a real-time teleophthalmology service for rural Western Australia (WA). DESIGN Service evaluation by prospective audit. SETTING Includes general practices, optometrists, hospitals in rural WA and the Lions Eye Institute in Perth. PARTICIPANTS Eighty-five patients from rural WA participating. INTERVENTIONS Video consultation (VC) with a general ophthalmologist. MAIN OUTCOME MEASURES Number of referring practitioners and their locations, software and imaging equipment used as well as the presentation, working diagnosis and follow-up plan for each consultation. RESULTS Eighty-five participants took part in a total of 100 VCs in the 5-month data collection period. There were 49 men (58%); age range 7-92 years; 31 identified as Indigenous Australian (37%). Participants were referred by optometrists (59%), hospital district medical officers (23%) and GPs (18%). Karratha (41%), Albany (20%) and Broome (14%) were the main VC locations. There were 31 different eye conditions managed; red eye, acute vision loss, known glaucoma and abnormal retinal photographs were the main presentations. Skype was the commonly used software (71%). Images were provided in 63% of all VCs. The main equipment used included digital retinal cameras (56%), smartphones (25%) and digital slit lamps (13%). An outpatient appointment with the ophthalmologist was recommended following 35 VCs. CONCLUSIONS Optometrists used this service most frequently, despite a lack of financial incentive. Digital retinal cameras and smartphones were the most commonly used imaging modalities. Overall, real-time teleophthalmology was used in the management of a broad range of eye conditions and was a useful supplement to outreach ophthalmology services.