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The British Journal of Ophthalmology Aug 2022To assess the accuracy of real-time telemedicine to diagnose and manage paediatric eye conditions.
BACKGROUND/AIMS
To assess the accuracy of real-time telemedicine to diagnose and manage paediatric eye conditions.
METHODS
Prospective, non-inferiority study analysing agreement in diagnoses and management plans between telemedicine and in-person examinations. Paediatric ophthalmology clinic. Children 0-17 years, English-speaking or Spanish-speaking, able to participate in age-appropriate manner, either previously seen by the optometrist and required ophthalmology referral or newly referred from outside source. Paediatric optometrist conducted examinations using digital equipment and streamed live to a paediatric ophthalmologist who recorded diagnoses and management plans, then re-examined patients in-person. Subjects were masked to the fact they would see the ophthalmologist in-person, same-day. Discrepancy in management plan or diagnosis between telemedicine and in-person examinations. Non-inferiority threshold was <1.5% for management plan or <15% for diagnosis discrepancies.
RESULTS
210 patients participated in 348 examinations. 131 (62.4%) had strabismus as primary diagnosis. In these patients, excellent and almost perfect agreement was observed for angle measurements (intraclass correlation coefficients=0.98-1.00) and disease categorisation (kappa=0.94-1.00) (p<0.0001 in all cases). No primary diagnoses changed, and no management plans changed following in-person examination. 54/55 patients who consented for surgery at the initial visit did so while masked to receiving an in-person examination. Families felt comfortable with the quality of the telemedicine examination (98.5%) and would participate in another in the future (97.1%).
CONCLUSION
Paediatric ophthalmic conditions can be reliably diagnosed and managed via telemedicine. Access for underserved populations may be improved by collaboration between ophthalmologists and optometrists using this technology.
Topics: Child; Humans; Ophthalmology; Prospective Studies; Referral and Consultation; Reproducibility of Results; Strabismus; Telemedicine
PubMed: 33722800
DOI: 10.1136/bjophthalmol-2020-318385 -
Canadian Medical Association Journal Feb 1978
PubMed: 20312954
DOI: No ID Found -
Clinical & Experimental Optometry May 2017
Topics: Australia; Eye Diseases; Humans; Optometrists; Optometry; Surveys and Questionnaires
PubMed: 28445924
DOI: 10.1111/cxo.12545 -
Journal of Optometry 2018Corneal refractive surgery procedures are widely performed to permanently correct refractive errors. Overall, refractive surgeries are safe, predictable and present high... (Review)
Review
Corneal refractive surgery procedures are widely performed to permanently correct refractive errors. Overall, refractive surgeries are safe, predictable and present high rates of satisfaction. Nevertheless, the induced epithelial, stromal and nerve damage alters corneal integrity and function, triggering a regenerative response. Complications that arise from corneal wound healing process might directly impact on visual outcomes of keratorefractive procedures. Most of these complications can be prevented or effectively treated with minimal consequences and minor impact on optical quality. Nevertheless, it is crucial to accurately and timely identify these corneal regeneration-related complications for successful counseling and management. Optometrists, as primary eye care providers, play an essential role in detecting anatomic and functional alterations in vision. It is therefore of great interest for optometrists to be familiar with the principal postoperative complications derived from alterations in regenerative process after corneal laser refractive surgeries. This review aims to provide a basis for optometrists to better understand, identify and manage the main wound healing-related complications after refractive surgery.
Topics: Cornea; Corneal Diseases; Corneal Surgery, Laser; Humans; Regeneration; Visual Acuity; Wound Healing
PubMed: 29183707
DOI: 10.1016/j.optom.2017.09.002 -
Clinical & Experimental Optometry Mar 2021The significant economic growth in China has resulted in a better quality of life. In order to cope with the demand for quality eye care, there are plans to increase the... (Review)
Review
The significant economic growth in China has resulted in a better quality of life. In order to cope with the demand for quality eye care, there are plans to increase the number of optometric personnel and to standardise the comprehensive eye-care services. This review aims to update the current educational programs in optometry and the regulations pertaining to the practice of optometry in China. There has been much progress since the publication of a report on the development of optometry in Greater China 15-years ago. China currently has three types of optometry programs: Diploma, Bachelor of Science, and Bachelor of Medicine. Only graduates of the Optometric Medicine program may perform full scope comprehensive eye-care services. Graduates from the other two types of programs may not use diagnostic or therapeutic pharmaceutical agents. The number of practising optometrists in China therefore needs to be planned by the Ministry of Education and the National Health Commission, accordingly.
Topics: China; Humans; Optometrists; Optometry; Quality of Life
PubMed: 32662082
DOI: 10.1111/cxo.13115 -
Clinical & Experimental Optometry Jan 2004
Topics: Child; Child, Preschool; Dyslexia; Female; Humans; Learning Disabilities; Male; Optometry; Professional Role; Sex Factors; Vision Disorders
PubMed: 14720112
DOI: 10.1111/j.1444-0938.2004.tb03137.x -
Eye (London, England) Apr 2022
Topics: Accreditation; Critical Pathways; Glaucoma; Humans; Optometry; United Kingdom
PubMed: 34702971
DOI: 10.1038/s41433-021-01820-7 -
Journal of Optometry 2020The pandemic of the severe acute respiratory syndrome disease caused by the new coronavirus SARS-CoV-2 (COVID-19), had profound impact in many countries and their health... (Review)
Review
The pandemic of the severe acute respiratory syndrome disease caused by the new coronavirus SARS-CoV-2 (COVID-19), had profound impact in many countries and their health care systems. Regarding Portugal, a suppression strategy with social distancing was adopted, attempting to break the transmission chains, bending the epidemy curve and reducing mortality. These measures seek to prevent an eventual National Health Service over-running, enforcing the suspension of all elective and non-urgent health care. Despite the success in so far, there is a consensus on the need to recover the previous level of health care provision and further enhance it. The Portuguese National Health Service, as a public, universal access, health care system funded by the State proved, in this context, its importance and relevance to the Portuguese population. However, long standing issues, such as the pre pandemic over long waiting lists for hospital ophthalmology attendance, whose determinants are fully identified but still unmet, emerge amplified from this pandemic. The lack of primary eye care in the National Health Service is a significant bottleneck, placing a huge stress on hospital-based care. An exclusive ophthalmologist's center care was over-runned before pandemic and will be even more so. The optometrist's exclusion from differentiated, multisectoral and multidisciplinary eye care teams remains the main hurdle to overcome and insure universal eye care in Portugal. National Health Service highlights the consequences of an overcome model. Universal eye care more than ever demands an evidence-based, integrated approach with primary eye care, in the community, on time and of proximity.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Delivery of Health Care; Eye Diseases; Humans; Infection Control; Infectious Disease Transmission, Patient-to-Professional; National Health Programs; Ophthalmologists; Optometrists; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Portugal; SARS-CoV-2; State Medicine
PubMed: 32711965
DOI: 10.1016/j.optom.2020.05.001 -
Clinical Optometry 2017Contact lens (CL) wear has been a viable alternative to spectacle wear for several decades. The interest and desire to wear CLs have been stable in recent years,... (Review)
Review
Contact lens (CL) wear has been a viable alternative to spectacle wear for several decades. The interest and desire to wear CLs have been stable in recent years, evidenced by the consistency of new wearers into this category of refractive correction. CLs have become one of the most commonly used medical devices in the market, with more than 40 million wearers in the US. There are many activities in which patients report a preference of CL wear over spectacles (athletics for example). Nearly all patients (even presbyopic patients) have the option of contact lenses today given the expansion of powers and parameters in recent years. Patients eyes are getting dryer as factors of age and the environment. CL materials have improved in recent years in an attempt to meet the challenges of dryer eyes. Despite the improvements in CLs and their care, challenges persist. Patient education, handwashing, compliance with care, and wearing schedule are some of the challenges that providers face in the care of CL patients even today.
PubMed: 30214367
DOI: 10.2147/OPTO.S139651 -
Clinical & Experimental Ophthalmology Mar 2020Cannabis is the most consumed illicit drug worldwide. As more countries consider bills that would legalize adult use of cannabis, health care providers, including eye... (Review)
Review
Cannabis is the most consumed illicit drug worldwide. As more countries consider bills that would legalize adult use of cannabis, health care providers, including eye care professionals (ophthalmologists, optometrists), will need to recognize ocular effects of cannabis consumption in patients. There are only 20 studies on the eyelid effects of cannabis usage as a medical treatment or a recreational drug. These include ptosis induction, an "eyelid tremor" appearance and blepharospasm attenuation. Six articles describe how adequately dosed cannabis regimens could be promising medical treatments for blepharospasm induced by psychogenic factors. Fourteen articles report eyelid tremors in intoxicated drivers and ptosis as a secondary effect in cannabinoid animal experimental models. The exact mechanism of cannabinoids connecting cannabis to the eyelids is unclear. Further studies should be conducted to better understand the cannabinoid system in relation to the eyelid and eventually develop new, effective and safe therapeutic targets derived from cannabis.
Topics: Animals; Blepharoptosis; Blepharospasm; Cannabinoids; Cannabis; Eyelids; Humans
PubMed: 31747112
DOI: 10.1111/ceo.13687