Teleophthalmology Implementation during COVID-19 Pandemic: Experience in Mexico City

Abstract

Background: Teleophthalmology (TO) is a fundamental tool to continue eye care delivery during the COVID-19 pandemic. TO programs allow follow-up of patients with chronic eye conditions, postoperative follow-up, triage, and referral of emergency conditions.Given the high risk of infection associated with ophthalmic examinations, TO enables safe and satisfactory interactions between patients and health care providers.Methods: We conducted a cross-sectional study to evaluate a TO program implemented in Mexico City, between April 1 st , 2020, and June 15 th , 2020. TO consults were offered via telephone and video visits. The program included tele-triage and follow-up consultations. Patients meeting referral criteria for emergency face-to-face (EFTF) evaluation were scheduled for in-person evaluation.Demographic clinical and ophthalmological information, as well as the Net Promoter Score (NPS) for assessing the general patient satisfaction, were obtained.Results: A total of 1,242 teleconsultations were conducted, including 1,159 first assessment consults and 78 follow-ups. The mean age of patients was 59 ± 18.6 years, most were females (57.5%) and had previous eye conditions (65.5%). The most frequent ocular condition presumed during teleconsultation was dry eye syndrome. The prevalence of ocular emergencies requiring EFTF assessment was 12.4%, with a 26.8% no-show rate and a positive predictive value of 51.9%. Patients reported high satisfaction with TO services (NPS = 86.9). Conclusion:TO stands as a viable alternative to limit COVID-19 transmission. Teleconsultation satisfaction rates are high, and most cases will not require immediate referral. Thus, TO programs may serve as a safe response to alleviate healthcare systems, while meeting patients needs during the pandemic.