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 manifest eyeglass prescription was calculated. RESULTS: The pilot study showed excellent percentage agreement between the screening protocol and the face-to-face exam. The percentage agreement for cataract was 100%, that for macular degeneration was 96%, and that for glaucoma suspect was 87%. The difference between the autorefraction's eyeglass prescription and the final manifest refraction was within American National Standards Institute for lens manufacturing guidelines. CONCLUSIONS: The initial data suggest that the tele-eye program is feasible to execute and appears fairly accurate when compared with the gold standard face-to-face eye exam. However, the study is significantly limited by the small sample size. This pilot provides justification of a much larger study of a similar design.
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 manifest eyeglass prescription was calculated. RESULTS: The pilot study showed excellent percentage agreement between the screening protocol and the face-to-face exam. The percentage agreement for cataract was 100%, that for macular degeneration was 96%, and that for glaucoma suspect was 87%. The difference between the autorefraction's eyeglass prescription and the final manifest refraction was within American National Standards Institute for lens manufacturing guidelines. CONCLUSIONS: The initial data suggest that the tele-eye program is feasible to execute and appears fairly accurate when compared with the gold standard face-to-face eye exam. However, the study is significantly limited by the small sample size. This pilot provides justification of a much larger study of a similar design.
Authors: Sarah E Miller; Suman Thapa; Alan L Robin; Leslie M Niziol; Pradeep Y Ramulu; Maria A Woodward; Indira Paudyal; Ian Pitha; Tyson N Kim; Paula Anne Newman-Casey Journal: Am J Ophthalmol Date: 2017-07-19 Impact factor: 5.258
Authors: Igor Kozak; John F Payne; Patrik Schatz; Eman Al-Kahtani; Moritz Winkler Journal: Graefes Arch Clin Exp Ophthalmol Date: 2017-04-26 Impact factor: 3.117
Authors: Atsushi Kawaguchi; Noha Sharafeldin; Aishwarya Sundaram; Sandy Campbell; Matthew Tennant; Christopher Rudnisky; Ezekiel Weis; Karim F Damji Journal: Telemed J E Health Date: 2017-08-07 Impact factor: 3.536
Authors: Rajvi Mehta; Derek Nankivil; David J Zielinski; Gar Waterman; Brenton Keller; Alexander T Limkakeng; Regis Kopper; Joseph A Izatt; Anthony N Kuo Journal: Transl Vis Sci Technol Date: 2017-01-20 Impact factor: 3.283
Authors: Ryan S Meshkin; Grayson W Armstrong; Nathan E Hall; Elizabeth J Rossin; Maggie B Hymowitz; Alice C Lorch Journal: Eye (Lond) Date: 2022-01-26 Impact factor: 4.456