Rural Eye Research Articles

Providing Cataract Surgeries at a Rural Primary Health Centre through Non-governmental Organisation Collaboration: An 8-year Experience

Abstract The National Programme for Control of Blindness and Visual Impairment aims to reduce blindness and visual impairment in India. Despite these efforts, rural areas still have high numbers of cataract patients due to inadequate healthcare services. Leveraging non-governmental organisation (NGO) networks to provide rural eye care camps has been proposed to address these challenges. This article shares an 8-year collaboration with an NGO in rural Haryana, delivering cataract surgeries. Initially, surgeries were conducted in temporary locations; however, due to complications, they were shifted to hospitals, increasing travel difficulties. In 2016, collaboration with ICARE Eye Hospital began, involving screening camps and transporting patients for surgery. This reduced patient expenses and referral burdens, performing 1690 surgeries with high satisfaction. Authors recommend similar collaborations to achieve the national blindness reduction goal.

Visual Outcome of Cataract Surgeries Performed in A Rural Eye Care Facility in the Philippines: A One-Year Retrospective Study

Visual Outcome of Cataract Surgeries Performed in A Rural Eye Care Facility in the Philippines: A One-Year Retrospective Study

Pattern of Eye Disease in Nenwe Rural Eye Clinic, Nigeria: A Seven Year Review

Background: The establishment of eye clinics in the form of rural outreach centers as a means of educating and providing eye care to rural residents was made necessary by the lack of eye care services in rural areas within Nigeria and the need to increase the cataract surgical rate among ophthalmologists in training. Understanding patterns of eye diseases in rural areas and eye health-seeking behaviors is crucial to achieving the goals of Vision 2020 especially for aspiring ophthalmologists. Aim and objectives: To examine the types of eye conditions observed at Nenwe, a rural outreach post of a tertiary hospital, and to evaluate their distribution. Methodology: A retrospective analysis of all patients who were seen at the community eye clinic during seven years was carried out. Records of patients at the Nenwe outreach eye clinic dating from November 2016 to August 2023 were examined, yielding information on patients examined during the period of study. Results: Glaucoma was the most common eye condition to be diagnosed. Cataracts were the second most common eye condition accounting for 20.8%. Other common eye illnesses were refractive error (9%), pterygium (7%), and allergic eye disease (6%) with 129, 101, and 95 cases, respectively. Retinal detachment (51 cases), prebyopia (47 cases), corneal lesion (58 cases), and dry eye condition (47 cases) were less common. Conclusion: The results show the burden of eye disorders in the Nenwe rural community and the importance of community-based eye care services.

A series of atypical cases of exudative retinal detachment with diagnostic dilemma presenting to a rural eye care center in South India

Abstract Introduction: Retinal detachment results due to the accumulation of fluid in the subretinal space. Retinal detachment can be rhegmatogenous, exudative, or tractional detachment. Exudative detachment occurs due to various choroidal or retinal pathologies. We report a case series of exudative retinal detachment (ERD) with atypical presentation, who were diagnosed and treated in our retina clinic. The aim of our study was to stress on the timely etiological diagnosis in patients who present with ERD in achieving a good visual recovery. We also would like to emphasize thorough systemic evaluation in the management of such cases. Materials and Methods: In this case series, patients who presented to our institution with ERD underwent a comprehensive ocular and systemic evaluation in order to determine the underlying etiology. Results: Our study showed that inflammatory causes, whether infectious or noninfectious uveitic conditions and certain systemic conditions unrelated to uveitis can also cause ERD. Conclusion: A thorough examination of both ocular and systemic condition is crucial for identifying the cause of ERD, ultimately aiding in the preservation of vision. In addition, timely recognition and management of any underlying systemic conditions by the appropriate specialist can significantly decrease the morbidity and mortality in these patients. The following core competencies are addressed in this article: Practice-based learning and improvement, Medical knowledge.

A practical model for effective eye care delivery in Southeast Asian rural communities: A proposal built based on experts' recommendations.

To evaluate rural community-based eye care models from the perspective of community ophthalmology experts and suggest sustainable technological solutions for enhancing rural eye care delivery. A semi-structured descriptive survey, using close-ended and open-ended questions, was administered to the experts in community ophthalmology sourced through purposive sampling. The survey was self-administered and was facilitated through online platforms or in-person meetings. Uniform questions were presented to all participants, irrespective of their roles. Surveyed participants (n = 22 with 15 from India and 7 from Nepal) in high-volume tertiary eye hospitals faced challenges with resources and rural outreach. Participants had mixed satisfaction with pre-operative screening and theatre resources. Delayed presentations and inexperienced surgeons contributed to the surgery complications. Barriers to rural eye care included resource scarcity, funding disparities, and limited infrastructure. In rural/peri-urban areas 87% of participants agreed with providing primary eye care services, with more than 60% of the experts not in agreement with the makeshift center model of eye care delivery. Key components for an effective eye care model are sustainability, accessibility, affordability, and quality. These can be bolstered through a healthcare management platform and a human-chain supply distribution system. Tailored interventions are crucial for rural eye care, emphasizing the need for stronger human resources, optimized funding, and community awareness. Addressing challenges pertinent to delayed presentation and surgical training is vital to minimizing complications, especially with advanced cataracts. Enhancements in rural eye care demand a comprehensive approach prioritizing accessibility, affordability, and consistent quality.

Medical librarians and little free libraries: Connecting rural communities to health information.

Consumer health libraries connect communities to reliable and accurate health information while Little Free Libraries (LFL) provide communities globally with access to free books with a 'take one leave one' type policy. To discuss how medical librarians used already established LFLs as outreach opportunities to provide consumer health books to rural locations in East Tennessee's Appalachia region in the United States. Researchers reviewed the population's literacy levels, the Index of Medical Underservice scores, and the availability of established LFLs. Twenty-two established LFL locations were selected and one new LFL was built for an eye clinic. Eleven health books were purchased for each established LFL, and 33 books were purchased for the new LFL. Researchers went back to each location 5 months after delivery. 90% of the books were taken from the already established LFLs. Ten books were taken from the new LFL. Using already established LFLs is a great opportunity to provide relevant health information to rural communities. The new LFL allowed for a partnership between the library and a rural eye clinic. By distributing health books to already established LFLs, researchers brought relevant health information books to rural and medically underserved communities.

Primary Pterygium Excision with Amniotic Membrane Grafting among Rural Eye Patients in Bangladesh

Objective: Since treatment of pterygium by topical and systemic medications is not effective, surgical treatment remains the only way to resolve the problem. This study was therefore aimed to evaluate the outcome of primary pterygium excision with amniotic membrane graft among patient with eye diseases in rural Bangladesh. Methodology: This study was conducted at the Pangsha Eye Hospital of District Rajbari among a total 280 pre-selected eye patients having primary pterygium over the period of 7 years (January 2012-June 2019). Surgical excision was performed with transplantation of preserved amniotic membrane on to the bare sclera. Every patient was followed up for at least next 6 months. Results: The results were evaluated in terms of recurrent pterygium growth and related complications. Of total 280 patients, pterygium was excision both of 138 (49.29%) being male and 142(50.71%) being female with mean ages of 43.36±10.88. The pterygium extended on to the corneas for 4.76±1.4 mm (range 3 to 8) mm. Only 11(4%) eyes demonstrated recurrent pterygium. Seven of them were male and 4 were female which was managed by second grafting leading to complete resolution. Of various complications, mild hematoma was observed in 3 cases, and, in 2 cases were had mild sclera dryness in bare scleral area after pterygium excision which were managed by topical steroid and artificial tear. Conclusion: Findings of this study yielded that primary pterygium excision with amniotic membrane transplantation is remains a safe and effective surgical technique with minimum recurrence rate. The Journal of Ad-din Women's Medical College; Vol. 11 (1), Jan 2023; p 4-13

Pattern of uveitis in a rural eye care hospital in Tamil

Pattern of uveitis in a rural eye care hospital in Tamil

School Vision Screening Data Informing a County-Based Community Health Needs Assessment

Purpose: The objective of this study was to (I) analyze Arkansas school nurse vision screening data, (II) provide a county-based pediatric vision care need assessment, and (III) evaluate eye care provider workforce in both rural and urban settings to overcome the vision screening follow-up care gap. Methods: Descriptive statistics and paired t-Tests (p < 0.05) were calculated for the number of students receiving vision screening, number of students referred to an eyecare provider, number of students receiving follow-up vision care, the vision screening referral rate, and follow-up rate for all public and charter schools in the state of Arkansas. Findings: The mean number of students screened in rural counties (mean +/- SD; 1530.5 +/- 1170.9) was statistically significantly (t-Test 2-tail, p = 0.003) lower than the mean number of students screened in urban counties (7301.10 +/- 7663.45). The referral rate was comparable in rural counties (9.41% +/- 4.95%), compared to urban counties (9.29% +/- 5.16%). Nearly two-thirds of the children who failed their vision screening did not receive a follow-up comprehensive eye exam (rural: 68.26% +/- 17.48%; urban: 66.30% +/- 11.91%). Rural counties had just 1.03 +/- 0.86 eye care providers per 10,000 people, compared to urban counties which had 1.30 +/- 1.11 eye care providers per 10,000 people. Conclusions: The purpose of school nurses screening children for vision abnormalities is to recognize and treat ailments early to ensure students have the best opportunity to learn. This study unveiled that rural and urban Arkansas school children alike go without follow-up eye care after failing their school vision screening two-thirds of the time. Rural areas have less eye care providers per capita and have a greater burden placed on each eye care provider, however, the follow-up care rate is comparable in rural and urban areas. Keywords:Rural Eye Care, Amblyopia; Nurse Vision Screening DOI: https://doi.org/10.14574/ojrnhc.v22i2.713

Eye care seeking behavior among rural adults in South India: Tamil Nadu Rural Eye Examination (TREE) Study Report 1.

To present the eye care seeking behavior among rural adults in South India. This cross-sectional study was conducted between 2019 and 2020 covering three blocks of the Thiruvannamalai district, Tamil Nadu, India. Door-to-door survey was performed to collect demographic information, status of literacy, occupation, and details of previous eye examination. Distance visual acuity was tested for individuals available in the house using a log MAR (logarithm of minimum angle of resonance) chart. Association between demographic details, details of previous eye examination, and status of vision was analyzed using logistic regression. A data of 12,913 individuals were included for the analysis, of which 6460 (50.03%) were females. Of the total individuals, 2007 (15.54%) had undergone an eye examination previously. There were 1639 (28.50%) people who had a vision less than 0.2 log MAR in at least one eye. The odds of reported 'previous eye examination' were more among females [odds ratio (OR) 1.48, 95% confidence interval (CI): 1.32-1.66, P < 0.001]; individuals aged above 60 years [OR: 11.46, 95% CI: 9.44-13.91, P < 0.001], between 40 and 60 years [OR: 10.43, 95% CI: 8.85-12.30, P < 0.001], and between 18 and 40 years [OR: 2.48, 95% CI: 2.16-2.84, P < 0.001]; illiterates (OR: 1.76, 95% CI: 1.45-2.15, P < 0.001); and farmers (OR: 1.32 95% CI: 1.12-1.55, P = 0.001). The study presents the utilization of eye care among rural South Indian adults. Almost 84.46% of individuals had not undergone any eye examination. Robust measures to promote eye care management would help in effective utilization of eye care services among rural adults.

Pattern of uveitis in a rural eye care hospital in Tamil Nadu

Aim: The aim of this study is to analyse the pattern of uveitis in a rural eye care hospital in Tamil Nadu. Understanding the shifting paradigm in uveitis, demographic differences in presentation, early diagnosis and treatment are very important in preventing ocular morbidity. Settings and Design: Retrospective Case study. Materials and Methods: Analysis of all the new cases of uveitis registered in our uvea clinic between December 2020 and April 2021 was done. Comprehensive eye examination and tailored investigations were done. Results: Among the 85 new cases of uveitis registered in the uvea clinic, 78 patients were included in the study. The mean age at presentation was 38.38 and ranged (4–77) years. The male: female ratio was 0.73. Anterior uveitis was the commonest type of uveitis (44.87%) followed by intermediate uveitis (24.35%), posterior uveitis (17.94%) and pan uveitis (12.82%). Aetiology was unknown in 30.76% (24/78) cases. HLA B27 association was noted in 22.8% of anterior uveitis cases. Sixteen patients had tuberculous aetiology. Ocular complications were noted in about 23.07% of patients and cataract was the most common complication. Conclusions: This study aims at analysing the pattern of uveitis in a rural area. Understanding the aetiology of uveitis whether infectious or autoimmune is of paramount importance to advice tailored investigations and to start early specific treatment. Delay in presentation and irregular follow-up, especially in patients from rural areas would result in permanent damage to ocular tissues and loss of visual function.

One-year Profile of Eye Diseases in Infants (PEDI) in secondary (rural) eye care centers in South India

Purpose:The aim of this study was to report the proportion and patterns of eye diseases observed among infants seen at two rural eye care centers in South India.Methods:A retrospective review of case records of infants seen between January 1, 2017 and December 31, 2017 at two rural secondary eye care centers attached to L V Prasad Eye Institute, Hyderabad. Data were collected regarding their demographic profile, the pattern of eye problems observed, management at the facility itself, and need for referrals.Results:During this period, a total of 3092 children were seen. Among them, 141 were infants (4.56%, 71 boys: 70 girls, median age: 8 months). Twenty-five percent of infants were less than 6 months of age. The most common eye problem was congenital nasolacrimal duct obstruction (n = 76, 53.90%), followed by conjunctivitis (n = 33, 23.40%), retinopathy of prematurity (n = 4, 2.84%) and strabismus (n = 3, 2.13%). One case each of congenital cataract and suspected retinoblastoma were identified. Majority of the cases (58.8%) belonged to the oculoplastic and orbital surgery sub-specialty. Sixteen percent of the infants (n = 23) had sight-threatening eye problems. Twenty percent (n = 28) were referred to tertiary care hospital for further management.Conclusion:Profile of eye disease in infants in secondary or rural eye care centers ranged from simple to complex, including sight-threatening diseases. While our study concluded that nearly 4/5th of these eye problems were simple and could be managed by a well-trained comprehensive ophthalmologist, 20% of these cases required a referral to a tertiary care center.

Detection of Posterior Segment Eye Disease in Rural Eye Camps in South India: A Nonrandomized Cluster Trial

Rural screening camps in India historically have focused on detection of cataract and uncorrected refractive error. This study aimed to increase detection, referral, and follow-up for posterior segment diseases (PSDs) in rural eye camps using a novel technology-driven eye camp model. A clustered nonrandomized trial in the catchment area of Aravind Eye Care System (AECS) Pondicherry, to compare 2 eye camp models: the traditional AECS eye camp model and the novel, technology-driven, eye camp model. Patients 40 to 75 years of age who attended free camps conducted by AECS Pondicherry. Those with corneal pathologic features were excluded because this precluded an adequate view of the posterior segment to screen for PSD. The clinical protocols in the 2 arms were standardized and the same study team was used in both study arms. The unit of allocation to the 2 study arms was at the level of the eye camp, rather than the level of the individual study participant. The primary study outcome was detection of suspected PSD (glaucoma, diabetic retinopathy, age-related macular degeneration, other PSDs). Secondary outcomes included: (1) the proportion of referred participants who underwent an examination at the base hospital and (2) the proportion with confirmed PSD on examination at the base hospital. The study included 11 traditional and 18 novel eye camps with a total of 3048 participants (50% in each study arm). The mean age of all participants was 58.4 ± 9.1 years and 1434 participants (47%) were men. The proportion receiving a referral for PSD was significantly greater in the novel (8.3%) compared with the traditional (3.6%) eye camp (P < 0.001; risk ratio, 2.31; 95% confidence interval, 2.30-2.34). Among the 183 participants referred from the camps for PSD, 73 (39.9%) followed up for further evaluation at the base hospital. In a resource-constrained setting, use of digital fundus photography in novel eye camps resulted in increased detection of and referral for PSD. Further research is needed to determine whether this intervention is cost effective and may contribute to prevention of avoidable blindness and visual impairment in South India. Further research also is needed to improve follow-up of patients referred from camps for suspicion of PSD.

How far would you travel to consult a rural Ugandan eye specialist? A cross-sectional study

Aims: Blindness and visual impairment are major public health concerns. However there is only 1 ophthalmologist per million individuals in Africa. Hence, individuals must travel long distances to see an eye specialist leading to reduced uptake of eye care services. The aims were to review patients’ demographics and geographical distribution, and conditions diagnosed at a rural eye clinic in Uganda. Methods: The ophthalmic clinical officer made handwritten records of attendees at the once-weekly morning clinic over a 14-week period. Data, including demographics, town of residence and diagnoses, were collated and analyzed. Results: During the study period, 273 participants attended the clinic (96 males, 177 females). On average, 19.5 patients were seen in the clinic per week. Patient ages’ ranged from 3 days to 89 years old (mean age=32.5 y). The commonest diagnoses were allergic conjunctivitis (9.9%), bacterial conjunctivitis (9.2%), pterygium (8.8%), presbyopia (8.8%), and blunt trauma (5.9%). Patients lived an average distance of 25.1 km from the clinic, with 23.0% living &gt;30 km away. Conclusion: The wide geographical distribution of attendees at the Ugandan eye clinic supports earlier research that these clinics are sparsely distributed requiring individuals to travel long distances to seek eye care services.

Commentary: COVID-19 lockdown-I and rural eye centers.

The year 2020 started as a year of celebration for the tremendous advances in ophthalmology that would make the promise of 20/20 visual acuity a reality for more people worldwide. Yet, our conventional perspectives have changed owing to changes following the coronavirus disease-2019 (COVID-19) pandemic on societies around the world[1] While the world is asked to stay home with social distancing recommendations, ophthalmology colleagues and their teams continue to provide urgent care to patients. Minimizing further loss of vision and its effect on patients and populations obviously requires the resumption of more regular eye care. We would benefit from a thorough understanding of how to ramp up eye care, both to describe lessons learned from COVID-19 and for insights relevant to potential future pandemics.[1] The COVID-19 pandemic is having a devastating impact on people, communities and economies, including health care and eye care.[2] This heightened concern was paralleled by patient fears, with the perception that many were opting to not pursue care for even urgent or emergent ophthalmic concerns. The cumulative effect of these delays on visual outcomes is not yet known, although it is estimated that there was a nearly 80% initial decrease in ophthalmology visits[3] and that as of mid-June there was still a cumulative decrease in ophthalmology visits of 40%.[4] A retrospective cross-sectional observational study conducted Varsha M. Rathi and colleagues in The Indian Journal of Ophthalmology is a useful addition to what is already known about the impact of COVID-19 on eye care. Lockdown-I in India severely impacted patient footfalls in rural centers. In the pre-lockdown period, theses centre received on an average 1100–1200 patients on a daily basis. During lockdown I, we could serve only 263 patients. Unlike pre-lockdown, where we had more female patients (52.3%), during lockdown we had more male patients (55.13%). It's likely that due to lockdown, there would have been issues related to accessing services by female patients, thus reducing their footfalls. The study shows, nearly 91% of the cases were managed at the rural centers and 9% needed a referral to higher centers, however, pre-lockdown the referral rate was 5.34%.[5] This was due to a higher number of specialty patients visiting during the lockdown, thus, increasing the referral rates. The presence of rural centers ensured care is provided at their doorstep, avoiding long travel for many of these patients during the lockdown. The authors recognize that to increase accessibility, patient care needs to be modified and improved to include a combination of in-person visits as well as teleconsultations.[5] Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Modifications to Combined Trabeculectomy and Manual Small Incision Cataract Surgery: Outcomes and Adaptability in Resource-constrained Areas.

We describe standardization and simplification of classic trabeculectomy combined with manual small incision cataract surgery (MSICS) to effectively manage the 2 leading and often coexisting causes of blindness and vision impairment in resource-constrained areas. The purpose of this study was to describe modifications to trabeculectomy combined with MSICS and report on the outcomes of this technique. The modifications consist of standardization and simplification of the surgical steps. Data obtained from adult patients who underwent described surgical technique at rural eye care centers across 3 Indian states between January 2018 and May 2019 were analyzed retrospectively. Complete success was intraocular pressure between 6 and 18 mm Hg without supplementary medication. Qualified success allowed up to 3 topical medication(s). Data are presented as median (first and third quartiles). We analyzed data of 70 eyes of 70 patients. Ophthalmology fellows performed 27 (38.5%) surgeries, whereas an experienced glaucoma specialist performed 43 (61.4%) surgeries. Patients were 63 (56, 67) years old. The preoperative intraocular pressure was 20 (16, 26) mm Hg on treatment with 3 (2, 3) antiglaucoma medications. Glaucoma was advanced by optic disc structural criteria in 58 (82.8%) eyes. Intraoperative mitomycin C was used in 5 (7.1%) eyes. Follow-up was 12.5 (6, 18) months. At 1 year, complete success (95% confidence interval) achieved was 55% (41-67), whereas qualified success was 83% (68-92) with 0 (0, 1) topical medications. The complete and qualified success rates did not differ between ophthalmology fellows and the glaucoma specialist (P=0.75 and 0.44, respectively). We present a straightforward, yet effective technique of combined cataract and glaucoma surgery. The technique has a potential for wider applicability, especially in the underserved regions of the world.

A study of leave against medical advice (LAMA) in eye camp patients of ophthalmology department in a tertiary care center

Introduction: To scientifically document and understand Leave Against Medical Advice (LAMA) characteristics of the patients selected for comprehensive eye care management from rural eye campsite. Methods: This was a cross-sectional study, where the demographic details, diagnosis, and details of LAMA were documented and then analyzed to find out if any peculiar pattern was seen among them. Results: Out of 840 patients over a period of 7 months, 26 (3.09 %) were seen leaving against medical advice, the majority being females (54 %). Most of the patients were in the age group of 61-70 years (42.3 %) and from long-distance camps (61.5%). They were accompanied by one of the family members (42.2%), with the majority of them leaving due to medical reasons (43.3%), seen mostly in the rainy season and festive months. Conclusion: LAMA is an indicator of the effectiveness of the community health care delivery system. Better insight into the reason requires understanding their social, economic, cultural, and educational status. Reducing the number of LAMA patients can have a positive impact on the optimal utilization of resources and improve the health status of the community.

English

English

Epidemiology of pediatric eye injuries requiring hospitalization in rural areas of Wenzhou and Changsha, China: a 10-year retrospective study

BackgroundThe aim of this study was to review the demographic and characteristic distribution data of serious rural pediatric eye injuries in Wenzhou and Changsha, located in Zhejiang Province in East China and Hunan Province in Central China.MethodsThis retrospective study included hospitalized pediatric patients aged < 18 years with eye injuries at the Eye Hospital of Wenzhou Medical University and Xiangya Hospital of Central South University from January 2008 to December 2017. Demographic data, injury types, injury causes, and initial and final visual acuity (VA) were recorded and analyzed. The ocular trauma score (OTS) was calculated to assess the severity of injury and evaluate the prognosis. All patient data were obtained from the medical record systems.ResultsIn total, 1125 children were hospitalized during the 10-year period; 830 (73.8%) were males and 295 (26.2%) were females. The majority of the patients were aged 3 to 8 years (57.4%, n = 646). Among mechanical injuries (n = 1007), penetrating injury was the most common (68.4%, n = 689), followed by contusion (17.2%, n = 173) and rupture (8.1%, n = 82). Overall, the top three injury causes were sharp objects (n = 544, 48.4%), blunt objects (n = 209, 18.6%) and fireworks (n = 121, 10.8%). In Wenzhou, eye injuries occurred mostly in summer (n = 136, 29.1%), and sharp object-related eye injuries accounted for the highest proportion (n = 98, 72.1%). In Changsha, eye injuries occurred mostly in winter (n = 272, 41.3%), and firecracker- and fireworks-associated eye injury accounted for the highest proportion (n = 73, 26.8%). The final VA was positively correlated with the initial VA (r = 0.641, P < 0.001) and the OTS (r = 0.582, P < 0.001).ConclusionThe age range of the susceptible pediatric population from rural areas was 3–8 years. Most eye injuries were penetrating, and the main cause of injury was a sharp object. Notably, the differences in the characteristics of eye injuries in the two areas were related to regional features.

Utility and Feasibility of Teleophthalmology Using a Smartphone-Based Ophthalmic Camera in Screening Camps in Nepal.

Purpose:To determine whether use of a mobile device-based ophthalmic camera by ophthalmic technicians (OTs) in village screening camps in Nepal followed by remote image interpretation by an ophthalmologist can improve detection of ocular pathology and medical decision-making.Design:Evaluation of mobile device-based ophthalmic camera through study of before and after clinical decision-making.Methods:One hundred forty patients over 18 years of age presenting to remote screening camps with best-corrected visual acuity ≤20/60 in one or both eyes were enrolled. Participants were examined by an OT with direct ophthalmoscopy. The technician recorded a diagnosis for each eye and a disposition for each patient. Patients then had anterior segment and fundus photos and/or videos taken using a smartphone-based ophthalmic camera system. Photos and videos were uploaded to a secure, HIPAA-compliant, cloud-based server, and interpreted by masked ophthalmologists from XXX, who independently recorded diagnoses and a disposition for each patient.Results:The diagnoses given by OTs and ophthalmologists differed in 42.4% of eyes. Diagnosis agreement was highest for cataract [k = 0.732, 95% confidence interval (CI) 0.65–0.81], but much lower for posterior segment (retina/optic nerve) pathology (k = 0.057, 95% CI −0.03–0.14). Ophthalmologists and OTs suggested different dispositions for 68.6% of patients. Agreement was highest for cataract extraction (k = 0.623, 95% CI 0.49–0.75), whereas agreement for referral to XXX was lower (k = 0.12, 95% CI 0.00–0.24).Conclusions:Remote ophthalmologist consultation utilizing a mobile device ophthalmic camera system is logistically feasible, easily scalable, and capable of capturing high-quality images in the setting of rural eye screening camps. Although OTs are well equipped to identify and triage anterior segment pathology, this technology may be helpful in the detection of and referral for posterior segment pathology.