Abstract
Telemedicine in ophthalmology (or teleophthalmology) has previously been described as being underwhelmingly utilized, playing a relatively minor role in clinical practice. The COVID-19 pandemic, however, has created a situation where telemedicine has become pivotal in order to maintain critical services. The objective of this review was to provide an overview of teleophthalmology and assess the potential impact of COVID-19 on its evolution A two-part pragmatic literature-review on teleophthalmology was performed in PubMed for (1) literature-reviews published between January 2010-to-June 2020 (2) studies reflecting the use of teleophthalmology associated with the COVID-19 pandemic. Guidelines developed by national authorities in response to COVID-19, were also assessed. A total of 27 published articles were identified: (seven literature reviews and 20 publications related to COVID-19), six national guidelines were also assessed. Diabetic retinopathy, glaucoma, age-related macular degeneration and cataract have received the most attention in the telemedicine literature. Concerning eHealth tools, one review identified 46 tools, which assessed near-and-distance vision – only one, however, was validated against gold-standard measures. Concerning the publications related to COVID-19: generally, teleophthalmology reduces the number of unnecessary visits, while also efficiently regulates ophthalmic emergencies, and was found to be associated with a high level of patient satisfaction. However, and in the case of live telehealth visits, it is important to recognize that some subspecialties are more suited than others. COVID-19 guidance from the Royal College of Ophthalmology (UK) and the American Academy of Ophthalmology, recommend telemedicine can be used for triage, the consultation itself, management and counselling. COVID-19 will likely serve as a catalyst for the transformation of teleophthalmology. Indeed, the current necessity to implement telemedicine for triage and consultations will likely have enduring effects. Furthermore, innovations in telemedicine, such as deep-learning prediction technologies and tele-robotics for surgery are advancing, and may have the potential to transform ophthalmic practice.
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