Introduction: The aim of this systematic review was to investigate the impact of tele-ophthalmology on screening, monitoring and treatment adherence in eye diseases.Material and Methods: A systematic review of controlled and randomized clinical trial studies without time limit was explored by searching keywords in the title, abstract and keywords of the studies in the reliable scientific databases Embase, Web of Science, Scopus, PubMed on April 20, 2022. A gray literature search was also conducted using the Google search engine to identify the most recent possible evidence. The quality of the studies was evaluated using the Joanna Briggs Institute (JBI) checklist; that the studies with a score above 7 were included in the analysis.Results: A total of 40 articles were identified after removing duplicates. After screening the full text of the articles, 5 studies met the inclusion criteria. In four of the studies, tele-ophthalmology was used for tele-screening and tele-monitoring using tele-imaging approaches, live video conferencing, and websites. Also, in one case, telemedicine reminder studies were used to improve treatment adherence. In the majority of studies, tele-ophthalmology was at least as effective as in-person visit services in screening, monitoring, and adherence to treatment.Conclusion: The results of our systematic review showed that a well-designed tele-ophthalmology program with high-quality cameras and equipment and the use of multiple technologies has the potential to replace or complement in-person visits to an ophthalmologist.