Feasibility of a Screening Ocular Disease Program by Teleophthalmology in Rural Colombia, South America

Abstract

Purpose : Emerging nations as Colombia in South America, have limited resources for specialty care to populations in remote, underserved geographic regions, so telemedicine has demonstrated to be an ideal tool to deliver eye healthcare in a rural scenario. The aim of the study is to determine the feasibility of a government funded teleophthalmology program to massively screen important diseases that impair vision in rural communities at the department of Santander located at eastern Colombia

Methods : A public awareness program on ocular diseases and the opportunity to participate in a screening campaign was funded and publicized by local authorities a few weeks in advance of such activity. A well-trained group of four optometrists and four nurses worked in an itinerant program with technological capabilities to forward information derived from a clinical assessment (including pinhole visual acuity, applanation tonometry, gonioscopy with a Sussman lens, fundus examination with a 90 D indirect lens) to a reading center at the capital of Santander. Positive cases underwent both anterior and segment photographs, as well as macular / optic nervehead OCT, which data were also sent to the reading center. Disease definition was established in order to refer positive cases to a specialty center and provide definite diagnosis and treatment, if necessary

Results : During a four-month period, 51 out of 87 municipalities of Santander, Colombia were covered by the intinerant teams. A total of 7,334 participants (4,510 female / 2,724 male), with a mean age of 64.7 years (S.D. = 13.8) were screened. Main diagnosis were: cataract (899 cases), closed / occludable irido-corneal angles (853 cases), pterygium (544 cases), glaucoma suspicion (337 cases), glaucoma (206 cases), diabetic retinopathy (27 cases). 924 subjects (12.6%) had more than one diagnosis. Diagnosis agreement between the teleophthlamology working team and the reading center was 91%. Most of the referred patients (96%) were treated according to the specific conditions that were diagnosed

Conclusions : An itinerant teleophthalmology program is a feasible option to screen for eye diseases in rural communities in Colombia, South America. Diagnosis confirmation and timely specific therapy might improve eye health standards of any given Colombian population through programs based on telemedicine principles

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.