Northern Alberta remote teleglaucoma program: clinical outcomes and patient disposition.
OBJECTIVE
To review the diagnostic outcomes and clinical referral pathways of patients assessed and managed through a collaborative care patient-centred teleglaucoma program.


METHODS
Retrospective cohort study.


METHODS
Eligible patients were those assessed by the referring optometrist or ophthalmologist to be open-angle glaucoma suspects or to have definite early open-angle glaucoma. A glaucoma specialist graded each case through virtual consultation. Clinical referral pathways were noted: in-person consultation with glaucoma specialist, repeat teleconsultation, collaborative glaucoma management with optometrist, or referral for nonglaucomatous ophthalmic pathology.


RESULTS
A total of 247 patients were referred to the program from 2008 to 2012. Of all teleconsults, 31.1% were diagnosed with glaucoma, 42.1% were suspects, and 26.7% were unaffected. Of all patients, 27% were referred for in-person glaucoma evaluation; 69% of patients could be managed by their referring optometrist, with 48% of patients requiring repeat teleconsultation. Treatment was initiated before being seen for 87% of patients with definite glaucoma and 28% of glaucoma suspects.


CONCLUSIONS
Of all patients seen through the remote teleglaucoma program, most did not require an in-person consultation with an ophthalmologist and could be managed through distance collaboration. For the approximately one third who were diagnosed with glaucoma based on virtual assessment, medication was started in the majority of cases and in-person consultation was arranged. Further studies to validate and consider cost-effectiveness of this system are under way.
Department of Ophthalmology, University of Alberta, Edmonton, AB.
Sanam
S
Verma
Department of Ophthalmology, University of Alberta, Edmonton, AB.
Sourabh
S
Arora
Division of Ophthalmology, Department of Surgery, University of Calgary, Calgary, AB.
Faazil
F
Kassam
Department of Ophthalmology, University of Alberta, Edmonton, AB.
Marianne C
MC
Edwards
Department of Ophthalmology, University of Alberta, Edmonton, AB. Electronic address: kdamji@ualberta.ca.
Karim F
KF
Damji
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis* / Q000628:therapy; D009885:Ophthalmology / Q000706:statistics & numerical data; D009907:Optometry / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000458:organization & administration*; D010808:Physical Examination / Q000706:statistics & numerical data; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D019114:Remote Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014130:Trabeculectomy; D055815:Young Adult
D000959:Antihypertensive Agents