Abstract
Objectives
To characterize the use of virtual visits, as well as compare the characteristics to in-person visits during the pandemic period.
Methods
This retrospective study included patients who had virtual and in-person ophthalmology visits from March 19, 2020, to July 31, 2020, in a large multispecialty ophthalmic center. Exclusion criteria included patients aged less than 18 years old; canceled, incomplete, mislabelled, and duplicated visits. 2943 virtual and 56,174 in-person visits were identified. A random sample of 3000 in-person visits was created. Each visit was analyzed as an individual data point.
Results
2,266 virtual visits (2,049 patients, 64.3% female, mean [SD] age 64.3 [16.6] years old) and 2590 in-person visits (2509 patients, 59.5% female, 65.9 [15.8] years old) were included. Most virtual visits were classified as comprehensive ophthalmology (34.6%), optometry-related (19.5%), and oculoplastics (13.0%). For in-person visits, the most common specialties were optometry (29.8%), comprehensive ophthalmology (23.9%), and retina and uveitis (17.3%). The most common diagnoses in the virtual group were from the eyelids, lacrimal system, and orbits group (26.9%), while in the in-person groups were choroid and retina conditions (19.3%).
Conclusions
Numerous ocular conditions were evaluated and managed through virtual visits, and external complaints and oculoplastic consults appear to be well-suited to the virtual format. Further studies focusing on visual outcomes and patient experience will be beneficial.
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References
Ribeiro AG, Rodrigues RAM, Guerreiro AM, Regatieri CVS. A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil. Arq Bras Oftalmol. 2014;77:214–8.
Kern C, Kortuem K, Hamilton R, Fasolo S, Cai Y, Balaskas K, et al. Clinical outcomes of a hospital-based teleophthalmology service: what happens to patients in a virtual clinic? Ophthalmol Retin. 2019;3:422–8.
Lee JX, Manjunath V, Talks SJ. Expanding the role of medical retina virtual clinics using multimodal ultra-widefield and optical coherence tomography imaging. Clin Ophthalmol. 2018;12:2337–45.
Tsaousis KT, Empeslidis T, Konidaris VE, Kapoor B, Deane J. The concept of virtual clinics in monitoring patients with age-related macular degeneration. Acta Ophthalmol. 2016;94:e353–5.
Barrett C, O’Brien C, Loughman J. Glaucoma referral refinement in Ireland: managing the sensitivity-specificity paradox in optometric practice. Ophthalmic Physiol Opt J Br Coll Ophthalmic Opt. 2018;38:400–10.
Sharma M, Jain N, Ranganathan S, Sharma N, Honavar SG, Sharma N, et al. Tele-ophthalmology: need of the hour. Indian J Ophthalmol. 2020;68:1328–38.
Rathi S, Tsui E, Mehta N, Zahid S, Schuman JS. The current state of teleophthalmology in the United States. Ophthalmology. 2017;124:1729–34.
Ting DS, Gunasekeran DV, Wickham L, Wong TY. Next generation telemedicine platforms to screen and triage. Br J Ophthalmol. 2020;104:299–300.
Johnson KA, Meyer J, Yazar S, Turner AW. Real-time teleophthalmology in rural Western Australia. Aust J Rural Health. 2015;23:142–9.
Sommer AC, Blumenthal EZ. Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak. Graefe’s Arch Clin Exp Ophthalmol. 2020;258:2341–52.
Mueller KJ, Potter AJ, MacKinney AC, Ward MM. Lessons from tele-emergency: improving care quality and health outcomes by expanding support for rural care systems. Health Aff. 2014;33:228–34.
Kilduff CLS, Thomas AAP, Dugdill J, Casswell EJ, Dabrowski M, Lovegrove C, et al. Creating the Moorfields’ virtual eye casualty: Video consultations to provide emergency teleophthalmology care during and beyond the COVID-19 pandemic. BMJ Heal Care Inform. 2020;27:1–5.
Bourdon H, Jaillant R, Ballino A, El Kaim P, Debillon L, Bodin S, et al. Teleconsultation in primary ophthalmic emergencies during the COVID-19 lockdown in Paris: experience with 500 patients in March and April 2020. J Fr Ophtalmol. 2020;43:577–85.
Arntz A, Khaliliyeh D, Cruzat A, Rao X, Rocha G, Grau A, et al. Open-care telemedicine in ophthalmology during the COVID-19 pandemic: a pilot study. Arch Soc Esp Oftalmol. 2020;95:586–90.
David W, Parke II M. Recommendations for urgent and nonurgent patient care. American Academy of Ophthalmology. 2020. https://www.aao.org/headline/new-recommendations-urgent-nonurgent-patient-care
Bureau USC 2010, American Community Survey, Median Household Income. 2010. https://data.census.gov/cedsci
Patel S, Hamdan S, Donahue S. Optimising telemedicine in ophthalmology during the COVID-19 pandemic. J Telemed Telecare. 2020. https://doi.org/10.1177/1357633X20949796. Online ahead of print.
Khor WB, Yip L, Zhao P, Foo VHX, Lim L, Ting DSW, et al. Evolving practice patterns in Singapore’s Public Sector Ophthalmology Centers during the COVID-19 pandemic. Asia-Pacific. J Ophthalmol. 2020;9:285–90.
Lai KE, Ko MW, Rucker JC, Odel JG, Sun LD, Winges KM, et al. Tele-neuro-ophthalmology during the age of COVID-19. J Neuroophthalmol. 2020;40:292–304.
Kang S, Thomas PBM, Sim DA, Parker RT, Daniel C, Uddin JM. Oculoplastic video-based telemedicine consultations: Covid-19 and beyond. Eye. 2020;34:1193–5.
Jamison A, Diaper C, Drummond S, Tejwani D, Gregory ME, Cauchi P, et al., Telemedicine in oculoplastics: the real-life application of video consultation clinics. Ophthalmic Plast Reconstr Surg. (2020)
Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA. Gender differences in the utilization of health care services. J Fam Pr. 2000;49:147–52.
Vogels EA, Millennials stand out for their technology use, but older generations also embrace digital life. 2019. https://www.pewresearch.org/fact-tank/2019/09/09/us-generations-technology-use/
Hammersley V, Donaghy E, Parker R, McNeilly H, Atherton H, Bikker A, et al. Comparing the content and quality of video, telephone, and face-to-face consultations: a non-randomised, quasi-experimental, exploratory study in UK primary care. Br J Gen Pr. 2019;69:E595–E604.
Annaswamy TM, Verduzco-Gutierrez M, Frieden L. Telemedicine barriers and challenges for persons with disabilities: COVID-19 and beyond. Disabil Health J. 2020;13:100973.
Turner SD, Digital denied: the impact of systemic racial discrimination on home-internet adoption. 2016. https://www.freepress.net/sites/default/files/legacy-policy/digital_denied_free_press_report_december_2016.pdf
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CCSV was responsible for extracting and analyzing data, managing the project, interpreting results, updating references, and writing the manuscript. JCM was responsible for extracting and analyzing data, interpreting results, updating references, and writing the manuscript. AII was responsible for extracting and analyzing data. MK was responsible for designing the review protocol and extracting data. AK was responsible for extracting data and managing the project. SG contributed to extracting data and creating tables. MO contributed to extracting data. AR was responsible for designing the research project and reviewing the manuscript. RPS was responsible for designing the research project, administering the project, and reviewing the manuscript. KET was responsible for designing the research project, administering the project, interpreting results, and reviewing the manuscript.
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CSV, JCM, AII, MAK, AK, SWG, and MO report no conflicting interests. AR reports personal fees from Alcon, personal fees from Allergan, research and personal fees from Genentech, research and personal fees from Novartis, personal fees from Regeneron, personal fees from Samsara, and personal fees from Zeiss. RPS reports personal fees from Genentech/Roche, personal fees from Alcon/Novartis, grants from Apellis, grants from Graybug, personal fees from Zeiss, personal fees from Bausch+Lomb, and personal fees from Regeneron Pharmaceuticals, Inc. KET reports research fees from Zeiss and personal fees from Genentech/Roche.
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Valentim, C.C.S., Muste, J.C., Iyer, A.I. et al. Characterization of ophthalmology virtual visits during the COVID-19 pandemic. Eye 37, 332–337 (2023). https://doi.org/10.1038/s41433-022-01938-2
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DOI: https://doi.org/10.1038/s41433-022-01938-2
