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

• 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
• ISSN: 1357-633X; 1758-1109
• DOI: 10.1177/1357633x13476233

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.