Teleophthalmology

Today, applications of teleophthalmology encompass access to eye specialists for patients in remote areas, ophthalmic disease screening, diagnosis and monitoring; as well as distant learning.

Instead, trained technicians or nurses can acquire eye images, typically fundus photographs and optical coherence tomography (OCT) scans, and transmit them securely online to ophthalmologists for review.

Teleophthalmology provides a cost-effective diagnostic method, particularly beneficial in reaching remote populations and screening individuals at higher risk of eye diseases, such as those with diabetes.

Several population-based studies have used retinal imaging to relate ophthalmic abnormalities to general conditions, including hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment.

Teleophthalmology services can be provided primarily in two ways synchronously or asynchronously: Images of the eye can be captured non-invasively through various methods, generally by a technician or non-physician health care professional.

Computer software applications have been tasked with the automated assessment of retinal images to recognize lesions associated with an ocular disease of interest.

Specific approaches involve pattern recognition using trained artificial neural networks; feature extraction using edge-detection and region-growing techniques; and content-based comparison with previously adjudicated samples.

A number of teleophthalmology programs exist in Canada, including those in the provinces of Alberta, British Columbia, Manitoba, Newfoundland, Ontario, and Quebec.

As of January 2014, approximately 15,000 patients had been screened for diabetic retinopathy, across 15 community-hospital-based stationary locations, 44 First Nations communities and five primary care practices.

Teleophthalmology is provided by ophthalmologists from the University of British Columbia, and is supported by Alberta Health Service's proprietary Secure Diagnostic Imaging[permanent dead link‍] software.

Ten of these eleven programs use the Ontario Telemedicine Network teleophthalmology (TOP) service to transmit images to an ophthalmologist for evaluation.

In Ontario, the implementation of teleophthalmology has reduced the average wait time from six months to four weeks, for some diabetic patients to obtain retinal screening from a specialist.

[24] The PEEK (Portable Eye Examination Kit) program has screened 2500 people in Kenya, and incorporates geo-tagging to facilitate follow-up treatment and demographic research.

The project was led by Consultant Ophthalmologist Simon P Kelly, Royal Bolton Hospital and Ian Wallwork, Optometrist, and undertaken in Salford.

Some of them are listed below: Emerging techniques for eye image capture include ophthalmoscopes that can be combined with mobile devices, increasing portability and accessibility to the general public.

It serves to identify patients who are at risk of various types of retinopathy and allows further evaluation and early management resulting in considerable economic benefit.

[12] As such, teleophthalmology cannot be a true substitute for comprehensive eye examinations using traditional binocular observation with standard 7-field stereoscopic fundus photography.

Healthy eye fundus viewed through a retinal camera
Retinal image with signs of macular degeneration
A non- mydriatic Topcon retinal camera