A Case of Traumatic Hyphema Diagnoses by Telemedicine Between a Remote Island and the Mainland of Tokyo

Abstract

Chichijima Island, part of the Ogasawara Islands in Tokyo, is a remote island with a population of approximately 2,000, served by a few resident general practitioners (GPs). This case report discusses the application of teleophthalmology in managing pediatric ocular trauma on this remote island. A pediatric patient sustained an ocular injury from a badminton shuttlecock and was initially examined by a resident GP using a recordable slit-lamp microscope. The ocular images were transmitted to a mainland ophthalmologist through a telemedicine system. The specialist provided remote consultation and recommended further examination and treatment, leading to the patient's transfer to the mainland. The successful management of this case underscores the critical role of telemedicine in enhancing healthcare delivery in isolated regions. With advancements in medical technology, teleophthalmology is expected to become increasingly vital in providing specialized care in remote and underserved areas. The case highlights the importance of telemedicine in improving access to specialized medical expertise, ensuring timely and effective patient care, and potentially reducing the need for patient transfers to more equipped healthcare facilities.

Keywords: d to d; gp; remote medicine; smart eye camera; telemedicine (tm).

Figure 1. Teleophthalmology consultation from the resident general practitioner to an ophthalmologist in the mainland.

An anterior segment video of the eyes. Eyelid swelling and redness, a deep anterior chamber containing hyphema and cells, conjunctival hyperemia, and a normal corneal and lens appearance with no sign of any trauma-induced lens.

Figure 2. Findings in the ophthalmology facility.

The anterior segment examination showed persistent but improving eyelid swelling and redness, along with reduced hyphema. Fundus examination revealed retinal commotio in the upper periphery without any signs of retinal detachment or optic nerve head swelling.