Telemedicine benefits

Using a telemedicine system to assist ophthalmologists in developing countries with the diagnosis and management of various ophthalmic conditions can be successful, according to a study published in the January issue of Clinical Ophthalmology.

Itay BenZion from Doar Na Hof, Ha Carmel, Israel and Eugene Helveston from the Indiana School of Medicine, USA and ORBIS International compared diagnosis and treatment plans of local ophthalmologists, via ORBIS' telemedicine system Cyber-Sight, to those of ORBIS expert mentors.

Records of referrals of patients via Cyber-Sight to mentors with a diagnosis of either glaucoma, paediatric cataract, external disease or disorders related to the ocular adnexa requiring oculoplastic treatment were reviewed. Records recalled from the Cyber-Sight electronic archives included: medical history, images of clinical findings, partner diagnosis, partner treatment plan, mentor diagnosis, and mentor treatment plan. Partners' diagnosis and treatment plans were compared with those of the mentors. Based on results of prior studies, mentor opinions were those considered valid (Helveston et al., 2001).

A total of 135 cases were reviewed; 70 external disease, 42 oculoplastics, 16 glaucoma and seven paediatric cataract. The partner's diagnosis agreed with that of the mentor in 81% of glaucoma cases, 86% of paediatric cataract cases, 76% of external disease cases and 86% of oculoplastic cases. The local ophthalmologists were considered to have suggested the correct treatment plan in 56% of glaucoma cases, 71% of paediatric cataract cases, 70% of external disease cases, and 60% of oculoplastic cases. Mentors provided additional comments and suggestions for further study in more than three-quarters of the cases.

If one considers that the mentors are correct in each case, they offered a different diagnosis in 18% of cases and in terms of treatment, the mentors offered an alternate plan in more than a quarter of cases. However, it is still to be determined whether this type of consultation changes the outcome of treatment.