We review the use of telemedicine in glaucoma and its possible roles in the COVID-19 outbreak. We performed literature search of published articles of teleglaucoma on May 12, 2020, using search terms including “telemedicine” and “glaucoma”, limited to human studies, English language and published over the prior 10 years. This search strategy yielded a total of 14 relevant articles after manual curation. Of the 14 articles, 4 were from the same randomized control trial, 7 were prospective studies, 2 were retrospective studies,1 was descriptive analysis, and 1 was cost-effective analysis. Seven discussed the common ophthalmologic measurements used in teleglaucoma. Four demonstrated the cost effectiveness of the use of teleglaucoma and three articles investigated patient satisfaction with the use of teleglaucoma. Three articles investigated the correlation between teleglaucoma and face-to-face clinics. Five articles discussed the current use and opportunities of teleglaucoma. When compared to in-person care, teleglaucoma is more time- cost-effective, shows high patient satisfaction and fair to good agreement with in-person care; however, there is great variation in the reported sensitivity of glaucoma screening, warranting further studies to establish its efficacy. For glaucoma management, both the sensitivity and specificity must be further improved before it could be put into extensive use. Nevertheless, it is worthwhile for us to explore the possible extensive application of teleglaucoma in monitoring ‘glaucoma suspects’ and maintaining glaucoma follow-up during a pandemic outbreak to reduce the possible risk of transmission of infection.

Purpose: To review the effectiveness of topical ocular hypertonic saline in corneal edema. Methods: Online literature search of published articles on the effectiveness of topical hypertonic saline in corneal edema, bullous keratopathy (BK), and other associated corneal conditions in humans was performed on April 16, 2020. Results: A total of 16 articles were reviewed after curation by the authors for relevance, with 4 randomized control trials, 6 prospective studies, 4 retrospective studies, and 2 case reports. Efficacy of hypertonic saline eye drops varied widely, depending on the specific corneal disorder being treated. Six of the studies involved BK (edema involves epithelium), 2 in corneal edema limited to the stroma, 5 in Fuchs dystrophy, 3 in filamentary keratitis (the presence of filaments attached to corneal epithelium), 2 in recurrent corneal erosion, and 1 in jellyfish stings. There was limited efficacy for hypertonic saline in BK, whereas clinical improvement was noted in most studies for corneal edema without epithelial involvement, especially if associated with Fuchs dystrophy or corneal hydrops in keratoconus. Hypertonic saline also seems to be beneficial for other corneal disorders, such as filamentary keratitis and jellyfish stings, but not in recurrent corneal erosion. Adverse effects from topical hypertonic saline include a mild stinging or burning sensation, with no serious complications having been reported. Conclusions: Topical ocular hypertonic saline seems to be a safe and effective treatment in the management of less severe forms of corneal edema and other corneal disorders such as filamentary keratitis.

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