Telemedicine model to prevent blindness from familial glaucoma
Article first published online: 27 APR 2011
© 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 39, Issue 8, pages 760–765, November 2011
How to Cite
Staffieri, S. E., Ruddle, J. B., Kearns, L. S., Barbour, J. M., Edwards, T. L., Paul, P. and Mackey, D. A. (2011), Telemedicine model to prevent blindness from familial glaucoma. Clinical & Experimental Ophthalmology, 39: 760–765. doi: 10.1111/j.1442-9071.2011.02556.x
- Issue published online: 3 NOV 2011
- Article first published online: 27 APR 2011
- Accepted manuscript online: 15 MAR 2011 05:14AM EST
- Received 28 July 2010; accepted 11 February 2011.
Background: To develop, implement and evaluate a telemedicine model to reduce glaucoma blindness through the early detection of undiagnosed glaucoma in high-risk individuals.
Design: Prospective study, private ophthalmology practice and public outpatient clinics in Tasmania.
Participants: One hundred and thirty-three individuals with primary open-angle glaucoma were invited to enrol their first-degree relatives (FDRs) to undergo an eye examination. Within the study period, 211 FDRs were available for examination.
Methods: A registered nurse was trained to perform the required assessments. Clinical data were entered into a purpose-built database, converted to a portable document format and graded offsite by an ophthalmologist to determine the presence, absence or risk of developing glaucoma. Participants were notified of the grading result and recommendations for review.
Main Outcome Measures: Incidence of undiagnosed glaucoma in a high-risk population.
Results: Previously undiagnosed glaucoma was identified in 5% of those examined. For every 19 participants screened, one new case of previously undiagnosed case of glaucoma was identified. Additionally 15% of participants showed suspicious signs of glaucoma, and 6% had ocular hypertension.
Conclusions: A telemedicine model is an efficient method for screening, grading and notifying participants of examination results. Nurses can be adequately trained to undertake the initial screening examinations, with grading of the results performed offsite by a suitably qualified ophthalmologist. Targeted screening for glaucoma increases the yield of identifying individuals with undiagnosed glaucoma or those at greatest risk. Cost efficiencies for this model of glaucoma screening should be further explored and implemented to prevent blindness from familial glaucoma.