Benefits of using telemedicine in glaucoma screening and early diagnostics

Abstract

Purpose: To determine benefits of using telemedicine in glaucoma screening with the aim of early diagnostics of glaucoma. Methods: Active preventive screening was performed for 530 patients of age 35-65 at primary health care centers in 5 remote areas of Lithuania over 5 years. Patients’ visual acuity, intraocular pressure were tested, eye fundus image was taken and sent for specialist ophthalmologist evaluation. Optic nerve head measurement algorithm was used at screening. Digital handheld non-mydriatic eye fundus camera Smartscope M5 PRO (Optomed OY, Finland) was used in this study for obtaining images of the optical nerve head and transmission for specialist consultations. Different stages of glaucoma were compared within this study (early; advanced; late stage). Patient satisfaction was surveyed as part of this study. Results: 530 patients were screened, 1060 eye fundus images obtained. Based on the evaluation of eye fundus and optical nerve head, if glaucoma was suspected, additional tests were performed at the tertiary level health care institution. Of the 530 patients, there were 50 cases of suspected glaucoma. In 6% of cases of all patients, early glaucoma was diagnosed and timely treatment plan started. Conclusions: Screenings using telemedicine at remote locations with "traditional" screenings at a tertiary level health care institution showed that telemedicine, employing advanced high quality image technology and trained medical personnel at primary level health care institutions, can be effectively used for early diagnostics of glaucoma. Based on patient satisfaction surveys, virtually 100% of patients expressed satisfaction with the screenings near their home using telemedicine and would like them to be permanently continued.