Diagnosis and management of strabismus using telemedicine.
This study was undertaken to measure the effect of telemedicine consultation for diagnosis and treatment planning in cases of strabismus. Telemedicine consultation records of all patients on ORBIS Telemedicine Cyber-Sight that resulted in a final diagnosis of superior oblique palsy (SOP), Duane syndrome (DS), and Brown syndrome (BS) were collected. The following were then determined: (1) the clinical characteristics of patients in each category, (2) the diagnosis submitted by the doctor requesting consultation compared to the diagnosis determined by the mentor, and (3) the treatment plan submitted with the consultation request compared to the mentor's suggested plan. The clinical characteristics of patients with SOP, DS, and BS were similar to those reported in the literature. There were 89 with SOP, 131 with DS, and 50 with BS. Partners and mentors agreed on the diagnosis of SOP in 81% of cases, DS in 79% of cases, and BS in 72% of cases. Mentors agreed with the partners' proposed treatment plan in SOP 35%, DS 55%, and BS 52%. Mentors are likely to change the diagnosis proposed by doctors seeking consultation for strabismus in 25% of cases and provide a new treatment plan in more than 50% of cases. The clinical characteristics of those strabismus entities selected matched those found in the literature, making it likely that the cases as viewed on telemedicine presented a true clinical picture.
Helveston
Eugene M
EM
ORBIS International, 8020 Zionsville Road, Indianapolis, IN 46268, USA. ehelveston@msn.com
Neely
Daniel E
DE
Cherwek
D Hunter
DH
Smallwood
Lynda M
LM
D015331:Cohort Studies; D004370:Duane Retraction Syndrome / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000628:therapy; D009885:Ophthalmology / Q000379:methods; D011787:Quality of Health Care; D019114:Remote Consultation / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013285:Strabismus / Q000175:diagnosis* / Q000628:therapy*