The Value of Tele-Glaucoma Explored
Using technology to offer telehealth services to patients with glaucoma has the potential to eliminate the “first come first served” paradigm, noted Albert S. Khouri, MD, associate director, glaucoma division, Department of Ophthalmology and Visual Science at Rutgers University in Newark, NJ, during the American Academy of Ophthalmology’s 2018 annual meeting in Chicago.
“If you can have patients with the most advanced disease jump the line and be seen first–to me that is one of the most promising aspects of this technology,” he explained. While still in its infancy, several modalities have emerged. Tele-glaucoma is being tested as both a screening/triage and consultation tool. The technology can be used in either a synchronous (audio-visual) and asynchronous (capture-store-forward) fashion. Moreover, the technology can be used in a number of locations: the medical office, urgent care center, emergency department, and community health center, to name a few.
“Classically we have relied on tabletop equipment, but smaller cameras and wearable technology/cell phones appear to be capable of acquiring images,” said Dr. Khouri, though he acknowledged that thus far there have been no studies to validate that cell phones can be used for this purpose. But the technology is being tested. “Stimuli can be projected through a cell phone to various parts of the visual field. It appears to correlate well with standard perimetry; it has the ability to distinguish between normal and glaucoma eyes.”
Challenges at this early stage include lack of standards (especially compared with telehealth use for diabetic retinopathy screening); low patient follow-up and retention; and lack of health policy and reimbursement.” Dr. Khouri noted that the latter concern is addressed in the AAO’s Telemedicine for Ophthalmology Information Statement – 2018.
Khouri A. Tele-glaucoma. Talk presented at: AAO 2018 annual meeting; October, 26-30, 2018; Chicago.