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White without pressure (WWOP) and LD were the commonest peripheral retinal changes. One-third of high myopes with LD had more than one area in the same eye. Increasing AL was associated with LD and retinal holes. Studies in older adults should be conducted to develop clinical guidelines for the management of high myopes.

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Introduction The Singapore Armed Forces (SAF) recognises the potential benefits and looks to harnessing telemedicine for primary health care services. In this prospective self-controlled pilot study, we aimed to evaluate the safety, efficiency and user satisfaction outcomes of virtual care (VC) at a military medical centre. Methods Out of 320 patients seen during the study period, 28 were enrolled in this study and underwent on-premises VC, comprising digital symptoms collection and telemedicine in addition to the usual in-person physician consultation. Safety outcomes were measured based on the diagnostic concordance between physicians. Efficiency was measured based on consultation times, and user satisfaction was evaluated using a standard questionnaire. Results There was a higher caseload of both upper respiratory infections and dermatological conditions in our population, in which telemedicine performed well. In terms of safety, telemedicine achieved a mean diagnostic concordance of 92.8% compared to in-person consultations. In terms of efficiency, consultation times were 26.2% – or 2 minutes and 15 seconds – shorter on average with telemedicine ( p = 0.0488). User satisfaction was favourable, with 85.5% of patients satisfied with the VC experience. Discussion This study has been invaluable in showing that on-premises telemedicine is a safe, efficient and effective means to extend and increase our surge capacity for primary health care. Our results have given us reasonable confidence to explore a larger-scale implementation in our network of military medical centres in the future.