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July 22, 2020
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Telehealth offers arm’s-length glaucoma management

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The COVID-19 pandemic presented ophthalmologists with the difficulty of treating patients remotely, but the widespread introduction of telehealth could be a silver lining in glaucoma management, according to Sayoko Sy E. Moroi, MD, PhD.

Telehealth is here to stay. We are going to be seeing more technology development that will be patient-centered to help for glaucoma assessment,” Moroi, chair and director of the department of ophthalmology and visual sciences at the Ohio State University Wexner Medical Center, said at the virtual Prevent Blindness: Focus on Eye Health National Summit.

Pull quote infographic featuring Sayoko "Sy" Moroi, MD, PhD

The benefits of telehealth in treating glaucoma include limiting exposure time for patients and staff worried about infectious diseases, decreasing the wait times for appointments compared with in-office visits and increasing use of new technology to collect data.

The main domains of telehealth, as outlined by the American Academy of Ophthalmology, include live audio-video, also called synchronous telehealth, which consists of real-time communication between doctor and patient; store-and-forward, or asynchronous telehealth, which relies on recorded and transmitted medical information; remote patient monitoring, wherein the patient is taught to monitor and transmit health data; and mobile health, which depends on data transfer via communication platforms, such as mobile phones and fitness trackers.

“At our institution, like at a number of other institutions, many of us have quickly adopted hybrid telehealth appointments,” including drive-through IOP checks under an outdoor tent, Moroi said.

Another area is a hybrid combination appointment in which a patient is scheduled specifically for an appointment to check for vision, eye pressures, visual fields and imaging.

“Later, the physician goes ahead and interprets this data and subsequently follows up with a live audio-video appointment to inform the patient about his or her test results and what the next steps are,” she said.

Telehealth limitations include the high cost of the necessary equipment, in addition to a need for broadband access for patients and providers to make the technology viable. Questions remain regarding insurance coverage and potential impact on patient-doctor relationships, Moroi said.

Reference:

Telemedicine for ophthalmology information statement – 2018. www.aao.org/clinical-statement/telemedicine-ophthalmology-information-statement. Published February 2018.