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Optometric Management

Article

CLINICAL: Glaucoma

Consider Remote Care

By: AUSTIN LIFFERTH, OD, FAAO
Optometric Management June 1, 2022 Vol 57, Issue June 2022 Page(s): 49

Why and how to utilize “teleglaucoma”

Glaucoma has a disproportionate effect on the aged, those in rural areas, and those who have low socioeconomic status and health literacy.1-4 Additionally, the COVID-19 pandemic has had a similar unequal affect among similar populations, thus, further complicating care related to this chronic disease.2-5

“Teleglaucoma,” or the use of virtual eye care to help manage glaucoma,6 can enable physicians to provide care to patients remotely,4 potentially solving the barrier to care presented by the above situations.

Here, I explain why optometrists should consider employing teleglaucoma and how to go about it.

TELEGLAUCOMA: THREE TYPES4

1 Synchronous. Real-time videoconferencing between the provider and the patient.

2 Asynchronous. Images are forwarded/stored by a technician at a remote location and later viewed by a provider.

3 Hybrid. Images may be forwarded to a provider by a technician and they, in turn, conference live with the patient regarding results and disease management.

WHY?

One report, comprised of several studies, shows that between one-third and one-half of patients had favorable attitudes toward potentially using telemedicine for glaucoma care and were even more favorable about it after reviewing the associated nature and benefits of the telemedicine platform prior to utilizing it.2

Also, another report, comprised of several studies, reveals that 75% to 96% of patients preferred ‘teleglaucoma,’ due to its associated decreased patient wait times,4 which, thereby, further reduce the disease’s overall burden.

Most patients say they prefer a hybrid model for maximum efficiency and cost savings.5-8 (See “Teleglaucoma: Three Types,” above.) This model delivers high-quality care9 and is especially helpful among low-risk glaucoma suspects and ocular hypertension patients.10

HOW?

To implement teleglaucoma services, Gan et al recommend an action-step summary that includes well-trained personnel providing a thorough history and pretesting, integrating technology (i.e., VFs, OCTs, fundus photography, etc.) capable of providing accurate data, and an accessible, approachable provider to deliver evidence-based treatment.11

A VIRTUAL BOOST...

Teleglaucoma has revealed itself as timely technology we can utilize for the right patient at the right time. OM

REFERENCES

  1. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014 Nov;121(11):2081-90. doi: 10.1016/j.ophtha.2014.05.013.
  2. Rhodes LA, Huisingh CE, McGwin G, Girkin CA, Owsley C. Glaucoma Patient Knowledge, Perceptions, and Predispositions for Telemedicine. J Glaucoma. 2019;28(6):481-486. doi: 10.1097/IJG.0000000000001238.
  3. Mylona I, Dermenoudi M, Glynatsis NM, Glynatsis MN. Patient Adherence to Glaucoma Treatment During the COVID-19 Pandemic. Cureus. 2021;13(6):e15545. Published 2021 Jun 9. doi:10.7759/cureus.15545.
  4. Ertel MK, Kahook MY, Capitena Young CE. The Future Is Now: Incorporating Telemedicine into Glaucoma Care. Curr Ophthalmol Rep. 2021;9(3):88-95. doi: 10.1007/s40135-021-00269-x.
  5. Vinod K, Sidoti PA. How glaucoma care changed for the better after the pandemic. Curr Opin Ophthalmol. 2022;33(2):59-66. doi: 10.1097/ICU.0000000000000812.
  6. Lam PY, Chow SC, Lai JSM, Choy BNK. A review on the use of telemedicine in glaucoma and possible roles in COVID-19 outbreak. Surv Ophthalmol. 2021;66(6):999-1008. doi: 10.1016/j.survophthal.2021.03.008.
  7. Thomas SM, Jeyaraman MM, Hodge WG, Hutnik C, Costella J, Malvankar-Mehta MS. The effectiveness of teleglaucoma versus in-patient examination for glaucoma screening: a systematic review and meta-analysis [published correction appears in PLoS One. 2015;10(3):e0118688. Jeyaraman, Maya [corrected to Jeyaraman, Maya M]]. PLoS One. 2014;9(12):e113779. Published 2014 Dec 5.
  8. Gunn PJG, Marks JR, Au L, et al. Virtual clinics for glaucoma care - Patients’ and clinicians’ experiences and perceptions: a qualitative evaluation. Eye (Lond). 2022;36(1):209-218. doi: 10.1038/s41433-021-01467-4.
  9. Simons AS, Vercauteren J, Barbosa-Breda J, Stalmans I. Shared Care and Virtual Clinics for Glaucoma in a Hospital Setting. J Clin Med. 2021 Oct 19;10(20):4785. doi: 10.3390/jcm10204785.
  10. Jayaram H, Baneke AJ, Adesanya J, Gazzard G. Managing risk in the face of adversity: design and outcomes of rapid glaucoma assessment clinics during a pandemic recovery. Eye (Lond). 2021 Aug 10:1–5. doi: 10.1038/s41433-021-01738-0.
  11. Gan K, Liu Y, Stagg B, Rathi S, Pasquale LR, Damji K. Telemedicine for Glaucoma: Guidelines and Recommendations. Telemed J E Health. 2020;26(4):551-555. doi: 10.1089/tmj.2020.0009.
DR. LIFFERTH practices at Center for Sight. He is a member of the Optometric Glaucoma Society and a Glaucoma Diplomate of the American Academy of Optometry.” For additional glaucoma cases, you can also follow Dr. Lifferth on his Instagram account: glaucomaqd. Disclosures: None. Email him at glaucomaqd@yahoo.com.

DR. LIFFERTH practices at Center for Sight. He is a member of the Optometric Glaucoma Society and a Glaucoma Diplomate of the American Academy of Optometry.” For additional glaucoma cases, you can also follow Dr. Lifferth on his Instagram account: glaucomaqd. Disclosures: None. Email him at glaucomaqd@yahoo.com.

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