title: A novel tele-eye protocol for ocular disease detection and access to eye care services.
abstract: BACKGROUND
  Telemedicine can improve access to care, especially for rural patients, and ophthalmology is a field that lends itself readily to telemedicine because interpretation of photographs is a routine part of diagnosing eye disease and patient care. We developed a novel tele-eye protocol based on diabetic teleretinal screening. We performed a feasibility study to see if our tele-eye program was comparable to the gold standard face-to-face eye exam.
  
  
  METHODS
  Fifty-two subjects underwent the tele-eye protocol and then received a face-to-face exam. A masked reader reviewed the tele-eye data remotely and developed an impression and plan for the patient. The provider assessments from the face-to-face exams and the tele-eye exams were compared. Sensitivity, specificity, and percentage agreement were calculated for the tele-eye protocol, focusing on the most common age-related eye diseases: cataract, macular degeneration, and glaucoma. The difference between the autorefraction and manifest eyeglass prescription was calculated.
  
  
  RESULTS
  The pilot study showed excellent percentage agreement between the screening protocol and the face-to-face exam. The percentage agreement for cataract was 100%, that for macular degeneration was 96%, and that for glaucoma suspect was 87%. The difference between the autorefraction's eyeglass prescription and the final manifest refraction was within American National Standards Institute for lens manufacturing guidelines.
  
  
  CONCLUSIONS
  The initial data suggest that the tele-eye program is feasible to execute and appears fairly accurate when compared with the gold standard face-to-face eye exam. However, the study is significantly limited by the small sample size. This pilot provides justification of a much larger study of a similar design.
authors: 1 Department of Ophthalmology, Emory Eye Center , Atlanta, Georgia .
authors: April Y
authors: AY
authors: Maa
authors: Centrael
authors: C
authors: Evans
authors: William R
authors: WR
authors: DeLaune
authors: Purnima S
authors: PS
authors: Patel
authors: Mary G
authors: MG
authors: Lynch
mesh_terms: D005128:Eye Diseases / Q000175:diagnosis* / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D017216:Telemedicine / Q000379:methods*; D015351:Vision Screening / Q000379:methods