April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Web Based Stereoscopic Teleglaucoma - Early Experience of a Collaborative Care Model
Author Affiliations & Notes
  • E. sogbesan
    Ophthalmology, University of Alberta, Edmonton, Alberta, Canada
  • C. Rudnisky
    Ophthalmology, University of Alberta, Edmonton, Alberta, Canada
  • M. Tennant
    Ophthalmology, University of Alberta, Edmonton, Alberta, Canada
  • K. F. Damji
    Ophthalmology, University of Alberta, Edmonton, Alberta, Canada
  • Footnotes
    Commercial Relationships  E. sogbesan, None; C. Rudnisky, SDI, I; M. Tennant, SDI, I; K.F. Damji, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 205. doi:https://doi.org/
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      E. sogbesan, C. Rudnisky, M. Tennant, K. F. Damji; Web Based Stereoscopic Teleglaucoma - Early Experience of a Collaborative Care Model. Invest. Ophthalmol. Vis. Sci. 2010;51(13):205. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To improve access to glaucoma care thorough collaboration with optometrists who have appropriate infrastructure to enable teleglaucoma evaluation.

Methods: : Using proprietary software that has been validated for diabetic retinopathy assessment, digital stereoscopic disc images, visual fields and retinal/optic nerve imaging from patients who presented to an optometrist were analyzed and graded by a glaucoma specialist. Disc characteristics were evaluated. Fields and other tests were graded as normal, borderline or abnormal. A grading diagnosis was made and recommendations for follow up care provided.Data was extracted from the grading reports, entered into a database and analyzed using EPI info software. The final diagnoses were compared to the referring diagnosis for agreement.

Results: : Images and data from 28 patients referred over one year from urban (7%), semi urban (71%) and rural (22%) optometrists were analyzed. The M:F ratio was 2:3 with an average age of 60 (13 - 96yrs).Data and images provided by the optometrists included a brief history, VA, IOP (57% applanation and 30% NCT), CCT (52%), automated visual fields (82%), stereo digital nerve photos (100%) and imaging including HRT (77%) and OCT (4%). Anterior segment exam information was provided in 32% and gonioscopy in 14%.Patients were graded as OAG suspects (32%), definite POAG (25%), NTG (25%), ACG or suspects (7%) and non glaucomatous optic nerve cupping (11%). In approximately 50% of the patients, there was agreement in diagnosis between the referring optometrist and the grader.Only 4 patients (14%) were referred to a glaucoma specialist, an 85% reduction in consultation and this provided significant savings in terms of time of travel (average 4.8 hours /patient). 24 patients (86%) are currently followed by their optometrists and/or managed with glaucoma specialists.

Conclusions: : The teleglaucoma model presented can be effectively integrated into existing optometric clinics. This approach reduces the number of referrals and associated patients travel time. There is a need for better standardization of referral information.Improvement in anterior segment assessment by optometrists will enhance teleglaucoma grading and assessment.Acknowledgement: Contributing optometrists and Abshir Moalin

Keywords: optic nerve • imaging/image analysis: clinical • intraocular pressure 
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