A pilot trial of tele-ophthalmology for diagnosis of chronic blurred vision

We evaluated the accuracy of tele-ophthalmology in diagnosing the major causes of chronic blurring of vision. Thirty consecutive patients attending a primary eye-care facility in Singapore (the Ang Mo Kio Polyclinic, AMKP) with the symptom of chronic blurred vision were recruited. An ophthalmic tech...

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Bibliographic Details
Published in:Journal of telemedicine and telecare 2013-02, Vol.19 (2), p.65-69
Main Authors: Johnson Choon, Hwai Tan, Eugenie Wei, Ting Poh, Sanjay, Srinivasan, Tock, Han Tim
Format: Article
Language:English
Subjects:
Adult
Aged
Female
Humans
Male
Middle Aged
Ophthalmology - methods
Patient Satisfaction
Pilot Projects
Prospective Studies
Remote Consultation - standards
Sensitivity and Specificity
Singapore
Telemedicine
Vision Disorders - diagnosis
Visual Acuity
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Summary:We evaluated the accuracy of tele-ophthalmology in diagnosing the major causes of chronic blurring of vision. Thirty consecutive patients attending a primary eye-care facility in Singapore (the Ang Mo Kio Polyclinic, AMKP) with the symptom of chronic blurred vision were recruited. An ophthalmic technician was trained to perform Snellen acuity; auto-refraction; intraocular pressure measurement; red-colour perimetry; video recordings of extraocular movement, cover tests and pupillary reactions; and anterior segment and fundus photography. Digital information was transmitted to a tertiary hospital in Singapore (the Tan Tock Seng Hospital) via a tele-ophthalmology system for teleconsultation with an ophthalmologist. The diagnoses were compared with face-to-face consultation by another ophthalmologist at the AMKP. A user experience questionnaire was administered at the end of the consultation. Using face-to-face consultation as the gold standard, tele-ophthalmology achieved 100% sensitivity and specificity in diagnosing media opacity (n = 29), maculopathy (n = 23) and keratopathy (n = 30) of any type; and 100% sensitivity and 92% specificity in diagnosing optic neuropathy of any type (n = 24). The majority of the patients (97%) were satisfied with the tele-ophthalmology workflow and consultation. The tele-ophthalmology system was able to detect causes of chronic blurred vision accurately. It has the potential to deliver high-accuracy diagnostic eye support to remote areas if suitably trained ophthalmic technicians are available.
ISSN:1357-633X
1758-1109
DOI:10.1177/1357633x13476233