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April 21, 2022
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Addressing best practices, disparities key for future of telemedicine in ophthalmology

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WASHINGTON — Defining telemedicine-related education and best practices and addressing health disparities are important for the future of patient care in ophthalmology, according to a speaker here.

“We all remember that at the outset of March 2020, physicians across medicine were sent scrambling to use telemedicine for the first time,” Grayson W. Armstrong, MD, MPH, said at Eyecelerator@ASCRS. “They didn’t know quite how to do it, but they knew their patients needed long-term care.”

Grayson W. Armstrong

Ophthalmology was hit particularly hard early in the pandemic, Armstrong said, with 75% of patients reporting difficulties accessing ophthalmic care. Despite this, the average proportion of ophthalmology telemedicine visits across 2020 was 0%, he said.

By 2040, there will be an overwhelming demand for eye care services due to an aging population and increasing rates of global diseases such as diabetes, according to Armstrong. Both synchronous and asynchronous telemedicine models can be used to alleviate this increase in patient demand, he said. Synchronous telemedicine examples include real-time video calls with patients, while asynchronous telemedicine may involve a patient exchanging a photo or message detailing their condition with their physician.

Doctor-to-doctor telemedicine consultation may also be useful, Armstrong said, noting that the aspect of telemedicine he is most excited for is a hybrid model.

“A patient will come in for a testing-only visit to get all of the testing they would normally get in person anyway — a visual field, Goldmann applanation with a technician, fundus photographs and OCT — and then subsequently the physician reviews that information, hops on a video call and talks to the patient,” he said.