Remote VF testing
The next step is remote visual field testing, which is already here.
The Visual Fields Easy App, designed for the iPad, is being used in Nepal and other remote locations for screening, said Ying Han, MD, PhD, associate professor of ophthalmology, University of California San Francisco.
The more complex Melbourne Rapid Fields (MRF), also iPad-based, has a nearly 1:1 correlation between MRF results and a conventional Humphrey Visual Field (HVF) Analyzer. A free web-based perimetry test, Peristat, at www.keepyourisght.org, can be used on any computer screen 17 inches or larger.
“Tablet and online field exams can be performed reliably and consistently,” Dr. Han said. “All have a strong correlation with HVF and can be good glaucoma screening tools.”
The Eye Institute of Alberta also is using tele-ophthalmology. One program links patients and non-specialist providers in remote communities with specialists in Edmonton, Canada. Images and screening data are provided by optometrists.
“We do the grading in Edmonton as a glaucoma specialist group,” said Karim Damji, MD, MBA, professor and chairman of ophthalmology, University of Alberta Faculty of Medicine & Dentistry. “(We) make recommendations about the diagnosis and management plan. About a quarter of patients needed to come in for further evaluation and many can be managed remotely.”