Teleophthalmology and its impact- An eye disease pattern analysis in central India’s hot spot during COVID-19 pandemic

Abstract

Background: COVID-19 pandemic has put all of us in astonishment and concern about its management and survival of human being since there is a great risk of human to human transmission. Teleophthalmology can play a great role to overcome this situation. Earlier teleophthalmology was mainly limited to diagnoistic reachout camps for diabetic eye disease mainly without treatment benefit to the patient. Now with advancement in media technology and availability of good quality smart phones, it is possible to extend scope of teleophthalmlogy for the treatment of superficial ailments of an eye. Our aim of the study was to analyse the eye disease pattern and impact of teleophthalmology on its management in one of the hot centre of India, i.e. Indore, during pandemic period. Materials and Methods: This study is a retrospective, interventional data analysis of patients seen in one month of Lockdown in India, from 26 th March to 25 th April 2020. All the patients were given teleconsultation with the help of voice calls and still pictures; video call was used wherever it was feasible. In our study, we have divided patients in two groups, first is Tele OSD (Tele Ocular Surface Disorders) where diagnosis on 2D image or video was possible and second group were OED (Other Eye Disease) where in-person consultation was required before making diagnosis or offering treatment. Results: We have done analysis of total 119 patients records who made a call for eye problems between 26 th March2020 to 25 th April 2020. Out of 119 patients, 107 patients (89.91%) were in Tele OSD and 12 patients (10.08%) were in OED group. Telemedicine was prescribed in 103 patients (103/107, of tele OSD group-96.26%), of which 102 patients (95.32%) showed marked improvement or are cured on followup. Among the Tele OSD group who received the treatment (103 patients), 79 patients (76.99%) were of conjunctivitis, varying from infectious to allergic origin who responded very well to treatment offered. Conclusion: COVID-19 pandemic has changed the understanding of medical science. Previously telemedicine (more precisely teleophthalmology) used to be a tool for outreach patient diagnosis mainly in rural or suburb area, but now with the advancement of digital media and easy availability of smart phones, it can also be used in the management of common eye diseases, even in urban population.

Applications, benefits and challenges of telehealth in India during COVID-19 pandemic and beyond: a systematic review

“…Among these finalised articles, ten were published in 2020 [ 32 – 41 ], and nine were published in 2021 [ 42 – 50 ]. Included studies consisted of eleven cross-sectional studies [ 32 , 33 , 35 – 37 , 39 , 40 , 45 , 46 , 49 , 50 ] and eight cohort studies [ 34 , 38 , 41 – 44 , 47 , 48 ]. Studies covered the application of telehealth services for different medical issues, including ophthalmology ( n = 4) [ 32 , 39 , 41 , 46 ], neurology ( n = 4) [ 38 , 42 , 45 , 50 ], dermatology ( n = 2) [ 35 , 43 ], non-communicable diseases ( n = 4) [ 33 , 44 , 48 , 49 ], haematological illness ( n = 1) [ 37 ], orthopaedic issues ( n = 2) [ 36 , 47 ], respiratory illness ( n = 1) [ 34 ], and substance use disorders (SUDs) ( n = 1) [ 40 ].…”

“…Not as suitable as in-person consultations. 10 Agrawal and Agarwal, 2020 [ 41 ] Indore, Madhya Pradesh Analyse the impact of teleophthalmology in the management of eye diseases. Cohort study Patients with eye problems n = 119 Diagnosis and management of most of the cases of tele ocular surface disorders.…”

“…The telehealth application in assisting patients with eye problems was presented in four studies [ 32 , 39 , 41 , 46 ]. Notably, electronic medical records allowed for a quick response to patients with ophthalmology issues during the COVID-19 pandemic lockdown [ 32 ].…”

“…More than 80% of the consultations were from patients who had previously visited the clinic, and about 60% of ophthalmology patients were not prescribed for physical evaluation in person [ 39 ]. Teleophthalmology was used for both diagnosis and management of eye problems, especially any damage to the surface layers of the eye, namely the cornea and conjunctiva [ 41 ]. Further, it ensured continuity of care during the pandemic as a means of managing new as well as follow-up patients with most eye conditions [ 46 ].…”

“…Results from a survey of dermatologists revealed that almost 82% of respondents practised in an urban setting, and 50% had a private clinic of their own [ 35 ]. At the same time, teleconsultations have the potential to be accessed by patients in remote areas [ 32 , 34 – 36 , 41 , 50 ]. Virtual consultations save money and effort, particularly for patients from the rural areas as they do not have to travel long distances to get consultation and treatment [ 35 ].…”