Ophthalmic telemedicine during coronavirus pandemic

Telemedicine – or only in times of pandemic?

Telemedicine is medical consultations, monitoring of the patient’s health and provision of all other medical services remotely – by phone and via the Internet. Thanks to remote contact with a doctor, we can analyze the symptoms that plague us, consult the results of diagnostic tests, including X-rays, echograms, ECG, MRI, CT or ultrasound sent to the specialist.

With the availability of webcams, the doctor can see the patient, making it much easier for him to make a diagnosis. What’s more, through telemedicine it is possible to assist in difficult operations and procedures remotely (conducting medical consultations directly from the operating room). Its benefits are also enjoyed by paramedics operating in difficult conditions, such as during accidents or disasters.

The Telemedicine Section of the Polish Medical Association has been active since 2001. The Laws: on Medical Activity and on the Profession of Physician and Dentist (April 2016) include the mediation of telemedicine systems – a doctor decides on the health of a person after examining him or her in person or using telemedicine or communication systems.

Under normal circumstances, telemedicine is dedicated to people who, for various reasons, are unable to contact a doctor in person, such as:

• They live far from a health center or hospital,
• have diagnosed chronic conditions such as asthma, cardiovascular disease, diabetes, mental illness, and others that require frequent consultations that can determine their lives,
• are either post-stroke or disabled for other reasons and have limited mobility.

Is telemedicine applicable in ophthalmology?

The first telemedicine-based system in operation is the SMPT system for qualifying patients, for the drug program to treat the exudative form of AMD (to date, about 18,000 people have been qualified for the program).

As of November 2019, a pilot scientific and research program is underway in Poland under the direction of Prof. Robert Rejdak, head of the ophthalmology clinic at SPSK1 in Lublin. The project uses – for the first time in the world – state-of-the-art cameras for eye examinations using telemedicine.

– This equipment allows a very fast examination of the fundus of the eye. It involves taking an instant digital image using the angio-OCT method. It takes 10 seconds. For this, we do not have to dilate the pupils with a drop. The next 40 seconds are taken to be analyzed by artificial intelligence, that is, special computer programs that detect the characteristics of eye diseases. The result is practically on the spot, everything takes just a minute,” describes Prof. Rejdak.

Ophthalmic telemedicine during coronavirus pandemic

Natural disasters, such as the ongoing coronavirus pandemic, are times when telemedicine and online visits are crucial. This is because they either speed up diagnosis or enable the doctor to monitor the health of post-operative patients who may have various worrisome or incomprehensible symptoms. Access to help is easy and fast, which is especially important with regard to emergencies – after all, it is possible that the patient will nevertheless need outpatient intervention .

Given that personal contact between a doctor and a patient is undesirable during a pandemic – the risk of coronavirus infection is significant, especially since one can become infected while being a so-called asymptomatic patient – telemedicine is now growing into the primary means of communication.

Due to the epidemiological situation in Poland, taking into account our collective health and a quick return to everyday life, it has been decided to cancel and suspend all scheduled consultations carried out in ophthalmology offices. Ophthalmologists remain available to patients by phone and online. Should there be a need for surgical intervention (e.g., a foreign body in the eye), the doctor will direct the patient and show him where he will get help.

Keep in mind that in the current epidemic situation, it is worth refraining from wearing contact lenses, as it has been found that lens wearers are more likely to reach their hands to the face and may thus transfer coronavirus particles to the mucosal area, resulting in infection.

Also, the fact that we are subjected to home isolation, work remotely and rarely get out in the fresh air promotes eye irritation. Lenses can intensify this irritation, and the result of irritation can be conjunctivitis.