Teleglaucoma: Ready to Go?
Teleglaucoma: Ready to Go?
Telemedicine technologies and services allow today's ophthalmic clinicians to remotely diagnose, manage and monitor several ophthalmic conditions from a distance. But is this the case for glaucomas? There has been a proliferation of telemedicine friendly devices in recent years that improves the capabilities of the clinician in managing glaucomas. The existing instruments still need to align themselves with accepted industry standards. There are successful programmes running in several areas of the world. The safety and efficacy of these programmes needs further exploration. The inability of a single device or test to diagnose glaucomas satisfactorily has also hampered progress in remotely diagnosing these conditions. There is, however, significant potential for telemedicine-friendly devices to remotely monitor the progress of glaucoma and, thereby, reduce some of the workload on an overstretched health service.
Telemedicine, or telehealth, refers to the practice of medicine at a spatial and/or temporal distance by exchanging medical information via electronic communications. The key aspect in the development of telemedicine is the constantly evolving interaction between medicine and information and communication technology (ICT). Given that ICT can support data collection and exchange, this can enable improved communication and integration of clinical services. Radiology has been at the vanguard of telemedicine; electronic transfer of digital images between radiological departments is now standard practice because the images do not diminish in quality with transfer.
Telemedicine principles have already been successfully applied within ophthalmology in the National Health Service Diabetic Retinopathy Screening Programme and retinopathy of prematurity screening. A 'store and forward' approach is used whereby images/data acquired at one site are transferred to a remote grader who views these images at a different time. Alternative approaches include remote monitoring and interactive telemedicine where self-testing allows clinicians to monitor a patient, and real-time interaction may occur between the clinician and the patient.
Glaucoma management increasingly involves use of devices that are perceived to be 'telemedicine-friendly'. Automated perimetry, tonometry, corneal pachymetry, imaging of the optic disc, nerve fibre layer and anterior segment, may all generate digital outputs that can be transferred electronically and viewed remotely.
This review outlines the validity of remote review with current technology and work reported to date using remote technology in glaucoma detection and management. Papers included in this review were identified through pubmed searches using the keywords 'teleophthalmology', 'teleglaucoma', 'glaucoma imaging', 'glaucoma screening', 'glaucoma case detection', 'glaucoma progression' and 'IOP measurement'; references in English were included.
Abstract and Introduction
Abstract
Telemedicine technologies and services allow today's ophthalmic clinicians to remotely diagnose, manage and monitor several ophthalmic conditions from a distance. But is this the case for glaucomas? There has been a proliferation of telemedicine friendly devices in recent years that improves the capabilities of the clinician in managing glaucomas. The existing instruments still need to align themselves with accepted industry standards. There are successful programmes running in several areas of the world. The safety and efficacy of these programmes needs further exploration. The inability of a single device or test to diagnose glaucomas satisfactorily has also hampered progress in remotely diagnosing these conditions. There is, however, significant potential for telemedicine-friendly devices to remotely monitor the progress of glaucoma and, thereby, reduce some of the workload on an overstretched health service.
Introduction
Telemedicine, or telehealth, refers to the practice of medicine at a spatial and/or temporal distance by exchanging medical information via electronic communications. The key aspect in the development of telemedicine is the constantly evolving interaction between medicine and information and communication technology (ICT). Given that ICT can support data collection and exchange, this can enable improved communication and integration of clinical services. Radiology has been at the vanguard of telemedicine; electronic transfer of digital images between radiological departments is now standard practice because the images do not diminish in quality with transfer.
Telemedicine principles have already been successfully applied within ophthalmology in the National Health Service Diabetic Retinopathy Screening Programme and retinopathy of prematurity screening. A 'store and forward' approach is used whereby images/data acquired at one site are transferred to a remote grader who views these images at a different time. Alternative approaches include remote monitoring and interactive telemedicine where self-testing allows clinicians to monitor a patient, and real-time interaction may occur between the clinician and the patient.
Glaucoma management increasingly involves use of devices that are perceived to be 'telemedicine-friendly'. Automated perimetry, tonometry, corneal pachymetry, imaging of the optic disc, nerve fibre layer and anterior segment, may all generate digital outputs that can be transferred electronically and viewed remotely.
This review outlines the validity of remote review with current technology and work reported to date using remote technology in glaucoma detection and management. Papers included in this review were identified through pubmed searches using the keywords 'teleophthalmology', 'teleglaucoma', 'glaucoma imaging', 'glaucoma screening', 'glaucoma case detection', 'glaucoma progression' and 'IOP measurement'; references in English were included.
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