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A Practical Guide to Telehealth in Ophthalmology

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Digital Eye Care and Teleophthalmology

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Abstract

Recent advancements in ophthalmic imaging, telehealth, and simulation technology have catalyzed broad developments in multiple domains, ranging from remote diabetic screening to microsurgical training. Successful implementation of these initiatives relies on a customized approach that accounts for a variety of potential barriers to adoption. These factors range from resource allocation, geopolitical and social considerations, social determinants of health, among countless other logistical challenges. Given wide global disparities in healthcare access, the advent and success of teleophthalmology as a tool to bridge this disconnect has brought tremendous optimism to our field. While far from a replacement to traditional medical consultations, teleophthalmology can augment specialty care reach, particularly in under-resourced areas. This type of outreach provides an opportunity for patients to seek basic screening opportunities capable of reliably detecting many major ophthalmic pathologies such as glaucoma and diabetic retinopathy. In the realm of surgical education, wet lab training with animal or human cadaveric specimens, and more recently synthetic tissues, have been a mainstay of training programs globally. Advancements in virtual reality (VR) training have further augmented educational opportunities for learners globally, where the demand for surgical care for reversible vision loss is greatest. Specifically, training in manual small-incision cataract surgery (MSICS) allows experienced surgeons to treat reversible blindness from cataracts safely, efficiently, and effectively with minimal reliance on costly hardware and specialized surgical devices. HelpMeSee® (New York City, USA) is a non-profit organization that has pioneered a VR-based surgical training device that not only allows an immersive visual experience, but furthermore provides nuanced haptic feedback which realistically simulates human tissue dynamics during surgery. Virtual simulation offers numerous advantages, including the ability to provide objective feedback, track learning curves, and allow for the creation of a customizable curriculum without the hassle and cost of specimen-based simulation in a wet lab environment. Validation studies have indeed demonstrated reductions in complication rates for surgeons trained with VR resources. As the fidelity of these simulators continues to improve, broader adoption in surgical training programs will follow, and challenges in access to simulator training will continue to need to be addressed to improve accessibility.

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Acknowledgements

We are grateful for the excellent technical assistance of Rafael González-Flores, Virtual Classroom and Multimedia Department, Instituto Mexicano de Oftalmología (IMO), Querétaro, México.

Author information

Authors and Affiliations

  1. Retina and Vitreous Department, Instituto Mexicano de Oftalmología (IMO), Querétaro, México

    Vazquez-Membrillo Miguel & García-Roa Marlon

  2. Department of Ophthalmology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Anurag Shrivastava

  3. Retina and Vitreous Department, Centro Oftalmologico Virgilio Galvis, Fundación Oftalmológica Santander Foscal, Floridablanca, Colombia

    Arias-Gómez Alejandro

  4. Telehealth Department, Instituto Mexicano de Oftalmología (IMO), Querétaro, México

    López-Star Ellery, López-Star Bethania, Van Charles Lansingh & Vega-Lugo Jessica

  5. Research Department, Instituto Mexicano de Oftalmología (IMO) Help Me See, New York, NY, USA

    Van Charles Lansingh

  6. Voluntary Associate Professor, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    Van Charles Lansingh

  7. Simulation Based Training Department, Instituto Mexicano de Oftalmología (IMO), Querétaro, México

    Gonzalez-Daher Pamela & Diaz-Flores Teresa

Authors
  1. Vazquez-Membrillo Miguel
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  2. García-Roa Marlon
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  3. Anurag Shrivastava
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  4. Arias-Gómez Alejandro
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  6. López-Star Bethania
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  7. Van Charles Lansingh
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  8. Vega-Lugo Jessica
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  9. Gonzalez-Daher Pamela
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  10. Diaz-Flores Teresa
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Corresponding author

Correspondence to Van Charles Lansingh .

Editor information

Editors and Affiliations

  1. School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia

    Kanagasingam Yogesan

  2. Department of Veterans Affairs, VA Palo Alto Health Care System, Palo Alto, CA, USA

    Leonard Goldschmidt

  3. Department of Optometry and Vision Science, University of California, Berkeley, CA, USA

    Jorge Cuadros

  4. Miller School of Medicine, Bascom Palmer Eye Institute University of Miami, Miami, FL, USA

    Giselle Ricur

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Miguel, VM. et al. (2023). A Practical Guide to Telehealth in Ophthalmology. In: Yogesan, K., Goldschmidt, L., Cuadros, J., Ricur, G. (eds) Digital Eye Care and Teleophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-031-24052-2_2

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  • DOI: https://doi.org/10.1007/978-3-031-24052-2_2

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