Teleophthalmology: An Essential Tool in the Era of the Novel Coronavirus 2019

Meghana Kalavar; Hong-Uyen Hua; Jayanth Sridhar

Disclosures

Curr Opin Ophthalmol. 2020;31(5):366-373. 

In This Article

Integrating Teleophthalmology Into Emergency Department Workflows

Teleophthalmology can also be particularly useful in emergency departments to triage patients and help in situations where an immediate ophthalmic diagnosis is necessary (Figure 1b). On average, there are around 2 million visits to the emergency departments for eye-related problems every year.[46] Additionally, eye-related emergency departments visits are significantly more likely from April to June,[46] which overlaps with the timing of the COVID pandemic. Screening patients prior to seeing them in an emergency department will aid in determining whether the condition is emergent and whether an in-person visit is required. Furthermore, the majority of emergency departments do not have ophthalmologists on site,[46,47] making the ability to tele-consult an ophthalmologist extremely useful. One study showed that emergency department physicians consulting remote ophthalmologists after imaging patients' eyes using an iPhone 4S allowed for accurate and safe triage.[48] Similarly, technologies such as smartphone attachments to diagnose corneal diseases and nonmydriatic fundus photography are useful in helping emergency department physicians diagnose ophthalmic complaints.[49,50] Another study analyzing emergency department visits from 2006 to 2011 found that almost half of emergency department visits were nonemergent, and the most common eye-related diagnosis was conjunctivitis.[46] Fortunately, conjunctivitis is not a sight-threatening condition and can be easily diagnosed and treated over teleophthalmology.[51] The next two most common emergency department diagnoses were corneal abrasion and foreign bodies, both of which are emergent.[46] In emergent cases, teleophthalmology can also reduce the amount of time required to receive care.[52] Upon determining the emergent nature of the condition, the patient can avoid long wait times at the emergency room and directly be seen by an ophthalmologist. Particularly in the time of COVID, when unnecessary travel is discouraged, this ensures that patients make minimal nonemergent visits to the hospital.

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