Pan-tilt-zoom (PTZ) and omnidirectional cameras serve as a video-mediated communication interface for telemedicine. Most cases use either PTZ or omnidirectional cameras exclusively; even when used together, images from the two are shown separately on 2D displays. Conventional foveated imaging techniques may offer a solution for exploiting the benefits of both cameras, i.e., the high resolution of the PTZ camera and the wide field-of-view of the omnidirectional camera, but displaying the unified image on a 2D display would reduce the benefit of “omni-” directionality. In this paper, we introduce a foveated imaging pipeline designed to support virtual reality head-mounted displays (HMDs). The pipeline consists of two parallel processes: one for estimating parameters for the integration of the two images and another for rendering images in real time. A control mechanism for placing the foveal region (i.e., high-resolution area) in the scene and zooming is also proposed. Our evaluations showed that the proposed pipeline achieved, on average, 17 frames per second when rendering the foveated view on an HMD, and showed angular resolution improvement on the foveal region compared with the omnidirectional camera view. However, the improvement was less significant when the zoom level was 8× and more. We discuss possible improvement points and future research directions.