Application of tele-ophthalmology in remote diagnosis and management of adnexal and orbital diseases

Abstract

Purpose: To assess the feasibility of making a diagnosis of adnexal and orbital diseases by Tele-ophthalmological means.

Materials and methods: Tele-consultation for eye diseases was done for 3497 patients from remote areas of Tamilnadu as part of the rural tele-ophthalmology project of a tertiary eye care hospital during a period of nine months from October 2004 to June 2005. These patients were comprehensively examined on-site by optometrists. Using digitized images sent by store and forward technique and videoconferencing, the ophthalmologist made a diagnosis and advised treatment.

Results: Adnexal or orbital diseases were detected in 101 out of 3497 patients (2.88%). Medical treatment was advised to 13 of 101 patients (12.8%). Surgery was advised in 62 of 101 patients (61.28%) whereas 18 of 101 patients (17.8%) required further investigations at a tertiary center.

Conclusion: It was feasible to apply the satellite based tele-ophthalmology set-up for making a presumptive diagnosis and planning further management of adnexal and orbital diseases based on live interaction and digital still images of the patients.

Figure 1

Set up of the rural tele-ophthalmology project. A: Mobile van with dish antenna for satellite connectivity. B: Optometrist screening patients in the rural camps. C: Ophthalmologist at base hospital having real time interaction with the patient. D: The ophthalmologist as seen at the rural end of the teleconferencing link

Figure 2

Images as visible to the ophthalmologist at the base hospital through store and forward technique. A: Basal cell carcinoma of the lower lid. B: Thyroid eye disease.

Figure 3

Age wise distribution of patients showing maximum number of patients in economically productive age group

Figure 4

Anatomical distribution of the adnexal and orbital diseases showing maximum involvement of eyelids