The use of telemedicine in the diagnosis of ocular health condition in the pediatric population

Abstract Body:

Purpose: The research project aims to study the feasibility and accuracy of telemedicine for interpreting eye examinations, diagnosing amblyopia and its causes, as well as helping identify neurosurgical emergencies through the diagnosis of pupil abnormalities and paralytic strabismus in children under the age of 7 years.

Study Design: The first phase of this project involves assessing the inter-observer variability between four eye care professionals when performing eye examinations on 27 children. Phase 2 involves a direct eye examination of 160 children by an ophthalmologist, which is videotaped. The video of the eye examination is then watched by the remaining 3 eye care professionals to assess the level of agreement and accuracy of diagnosis using telemedicine.

Methods: All four eye care professionals in phase 1 examine the same child directly and perform a set of standard eye tests to reach a diagnosis. In phase 2, one eye care professional performs a direct eye examination on a child. This is video-taped and shown to the remaining three eye care professionals.

Results: We assessed the level of agreement of diagnosis between all four eye care professionals in phase 1 as 92%. The level of agreement for phase 2 is tentatively high.

Conclusions: The potential impact of the study results in terms of offering a new and innovative way of timely diagnosis and hence treatment of amblyogenic eye disease as well as diagnosing cranial nerve palsies in children is significant. It can help reduce the prevalence of individuals with unilateral or bilateral chronic visual impairment for life as well as allowing for expedition of urgent neurosurgical referrals requiring neuroimaging. With individuals in rural, remote and isolated areas having increased difficulty accessing secondary and tertiary health care services in larger centres and a lack of physicians working in remote communities, it is important to further research the use of tools such as telemedicine to maximize health care to the public.