Improved knowledge about glaucoma and a high intent to pursue eye care may lead to improved detection of early disease, thus lowering the risk of blindness among patients.
Reviewed by Lindsay Anne Rhodes, MD
Traditional in-office glaucoma screening and treatment approaches fail to reach many patients in the population, resulting in an increase of significant visual deterioration or even blindness. Community models that provide accessible, convenient, and efficient care to high-risk populations could be part of the solution, said Lindsay Anne Rhodes, MD, assistant professor, Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham.
“If we can make it easier and more convenient for patients to get to their appointments and have regular checks, maybe we will do a better job of finding them before their condition gets worse,” said Dr. Rhodes, who is participating in one teleglaucoma initiative, known as EQUALITY (Eye Care Quality and Accessibility Improvement in the Community).
Telemedicine is well established in the diagnosis of diabetic retinopathy and retinopathy of prematurity, but implementation has been slower for glaucoma, she said. Reasons include the need for a combination of structural and functional testing, often conducted with sophisticated, expensive instruments, and challenges such as image readability, and follow-up adherence.
A community model holds promise for improving the management of glaucoma, particularly in small towns, rural areas, and inner cities where specialized medical services are often limited or nonexistent.
Goals include providing accessible, convenient, and efficient care; using improved imaging and diagnostic modalities (portable fundus cameras, smartphone cameras, tablet- or virtual reality-based visual field testing, and spectral-domain optical coherence tomography); increasing rates of diagnosed and treated glaucoma; and allowing glaucoma specialists to focus on advanced disease and surgical work.
Projects being tested
Teleglaucoma projects are being tested in a number of areas, most falling into either of two categories. One is population-based detection targeting high-risk populations.
“Checking everybody for glaucoma is not a good way of finding the disease,” Dr. Rhodes explained. “If we can isolate high-risk populations based on age, race, and family history of glaucoma, it improves our ability to find and treat glaucoma.”
Lindsay Anne Rhodes, MD
E: [email protected]
This article is adapted from Dr. Rhodes’ presentation at the American Glaucoma Society 2019 annual meeting. Dr. Rhodes has received funding and support for the EQUALITY project from the Centers for Disease Control and Prevention, Research to Prevent Blindness, EyeSight Foundation, Carl Zeiss Meditec, and Heidelberg Engineering.