Telemedicine model to prevent blindness from familial glaucoma
Staffieri, SE and Ruddle, JB and Kearns, LS and Barbour, JM and Edwards, TL and Paul, P and Mackey, DA, Telemedicine model to prevent blindness from familial glaucoma, Clinical and Experimental Ophthalmology, 39, (8) pp. 760-765. ISSN 1442-6404 (2011) [Refereed Article]
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
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
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.