Use of Teleophthalmology for Evaluation of Ophthalmic Emergencies by Ophthalmology Residents in the Emergency Department

Shah, Yesha; Fliotsos, Michael J.; Alaqeel, Abdulaziz; Boland, Michael V.; Zafar, Sidra; Srikumaran, Divya; Woreta, Fasika A.

doi:10.1089/tmj.2021.0334

Cited by 4 publications

(15 citation statements)

References 23 publications

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“…Two studies included supervisees who were physicians, including an ophthalmic surgeon from a foreign country (14%) [ 9 ] and a general practitioner in a rural hospital (14%) [ 8 ]. Five studies included supervisees who were medical trainees, such as ophthalmology residents (43%) [ 7 , 11 , 13 ], vitreoretinal fellows (14%) [ 12 ], and emergency medicine (EM) residents (14%) [ 10 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Study setting varied between the ED [ 5 , 7 , 10 , 11 ], operating room (OR) [ 9 , 12 ], rural hospital [ 8 ], and eye clinic [ 13 ]. Virtual supervision was used for a clinical examination in three studies (43%) [ 7 , 11 , 13 ], surgical procedure in three studies (43%) [ 9 , 10 , 12 ], and in-office procedure in one study (14%) [ 8 ]. For studies involving a surgical or in-office procedure, VS was used to teach surgeons endoscopic laser-assisted dacryocystorhinostomy (ELA-DCR) [ 9 ], perform orbital decompression on a patient with extensive facial trauma [ 10 ], remove a corneal foreign body and rust ring in a rural hospital [ 8 ], and supervise retina fellows repairing macula-on rhegmatogenous retinal detachments (RRD) during bank holidays and weekends [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…Devices used for VS included an optical coherence tomography (OCT)/fundus camera [ 7 ], slit lamp camera [ 8 , 11 ], network camera [ 13 ], and ceiling-mounted camera (Table 4 ) [ 10 ]. Synchronous communication between the supervisor and supervisee was facilitated through various modalities such as email [ 11 ], telephone [ 11 ], video conferencing software [ 8 , 9 ], and local area network (LAN) [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

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Virtual supervision in ophthalmology: a scoping review

Kang

Shin

Greenberg

2023

Graefes Arch Clin Exp Ophthalmol

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Purpose The published information on virtual supervision (VS) in ophthalmology is not well described. This scoping review describes the evidence and potential role for VS in ophthalmic practice and education. Methods A literature search strategy was developed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included full-text articles published in an English-language peer-reviewed journal that involved physician-physician or physician-trainee VS in ophthalmology. We excluded studies with direct (in-person) supervision. Two investigators independently extracted from each article the year of publication and study location, design, participant characteristics, sample size, and outcomes. We appraised the methodological quality of the studies using the Mixed Methods Appraisal Tool (MMAT). Results Seven articles were included in our qualitative synthesis. Supervisees ranged from physicians such as an ophthalmic surgeon and a general practitioner to medical trainees such as ophthalmology residents, vitreoretinal fellows, and emergency medicine residents. Study settings included emergency departments, operating rooms, eye clinics, and a rural hospital. All studies reported successful transmission of real-time images or videos of clinical examinations and surgical or in-office procedures. Various methods were used to ensure high image and video quality during VS, although some technical challenges remained. MMAT ratings revealed limitations in outcome measurement, statistical analysis, sampling strategy, and inclusion of confounding factors. Conclusion Virtual supervision in ophthalmology is technologically feasible and permits synchronous communication and transmission of clinical data, which can be used to formulate diagnostic and management plans and learn new surgical skills. Future studies with larger sample sizes and robust study designs should investigate factors that make VS effective in ophthalmic practice and education.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Virtual supervision in ophthalmology: a scoping review

Kang

Shin

Greenberg

2023

Graefes Arch Clin Exp Ophthalmol

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“…The satisfaction of physicians is one of the key factors in determining the success of telemedicine as shown in many studies. [ 39 40 41 ]…”

Section: T Elemedicine and T Eleophthalm...mentioning

confidence: 99%

Teleophthalmology in Saudi Arabia

Kalantan

2023

Saudi J Ophthalmol

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Teleophthalmology is the provision of ophthalmic care using digital medical equipment and telecommunications technology. While teleophthalmology has been practiced since the 1990s, it became a crucial medical service during the COVID-19 pandemic when doctors were required to make diagnoses from a distance. This was certainly the case in Saudi Arabia, a relatively large country with limited medical workforce to meet demands, yet a high prevalence of diseases such as diabetes, glaucoma, and cataracts which are considered leading causes of visual impairment. In response to the pandemic, Saudi Arabia's Ministry of Health issued scientific instruction manuals and guidelines for health-care providers which paved the way for increased use of digital technologies and solutions to mitigate the health and economic impacts of COVID-19. The pandemic served to accelerate the use of virtual ophthalmology in Saudi Arabia with the most common teleophthalmology applications being teleconsultation and disease-specific applications such as diabetic retinopathy and retinopathy of prematurity. Although some challenges relating to implementing teleophthalmology in Saudi Arabia remain, it is felt that there are great opportunities to expand the use of telemedicine in ophthalmology in this country.

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Telemedicine at a University Ophthalmology Practice During the Beginning of the COVID-19 Pandemic

Oganov,

Chou,

Hanson

et al. 2024

OPTH

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Purpose The aim of the research was to evaluate the use of teleophthalmology at a university practice during the COVID-19 pandemic, specifically examining precision, effectiveness, and patient satisfaction. Patients and Methods Telemedicine visits were offered to new and established patients requesting appointments with the Stony Brook University Department of Ophthalmology between March 30 and June 2, 2020. Records from these visits were reviewed for chief complaint, past medical and ocular history, diagnoses, treatment/management, and providers’ sub-specialty. Precision was determined by comparing agreement between diagnoses of the telemedicine visit with those of the subsequent in-person visit. The decision to follow up in person was made by the physician and patient. Diagnostic precision as well as progression, improvement, or stability of patients’ symptoms were determined by the physician’s assessment at follow-up visits. Post-telemedicine visit satisfaction surveys were sent to all patients. Results Telemedicine visits were offered to 783 patients, 520 (66.4%) of whom accepted. Of these 520 patients, 409 (78.7%) were established and 105 (20.2%) had in-person, follow-up visits. Overall, the diagnostic precision of the follow-up visits was 89.5%. Precision differed significantly across ophthalmologic subspecialties. Of the patients who had in-person follow-up visits, 56.8% remained stable, 32.4% improved, and 10.8% worsened. Established patients presented with more extensive ocular histories/procedures and experienced a higher percentage of worsening symptoms/disease stage compared to new patients. Oculoplastics/orbit was the most prevalent diagnostic subspecialty that worsened. Surveys were sent to all patients completing telemedicine visits, 15.0% of whom responded. Overall satisfaction was 91.9%, although only 23.0% of respondents preferred telemedicine to an in-office visit. Conclusion Telehealth provides high levels of precision and patient satisfaction for a wide range of ophthalmologic visits, although most patients still prefer in-office examinations. Employing teleophthalmology for follow-up and emergency care may provide patients with an effective alternative during pandemic situations and beyond.

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Use of Teleophthalmology for Evaluation of Ophthalmic Emergencies by Ophthalmology Residents in the Emergency Department

Cited by 4 publications

References 23 publications

Virtual supervision in ophthalmology: a scoping review

Virtual supervision in ophthalmology: a scoping review

Teleophthalmology in Saudi Arabia

Telemedicine at a University Ophthalmology Practice During the Beginning of the COVID-19 Pandemic

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