Andrew_Doan said:
Tele-medicine may change the roles of optometry, ophthalmology, and family practice:
http://www.eyeorbit.org/article.php?story=20050414001120920
Andrew,
I think it's already happening. I had a patient come in with a letter from his GP advising him to come in for a "retina-scan" or something similar. The GP is an internist, not a diabetic specialist or even endocrinologist. And I've heard of similar situations in which PAs are actually reading the photos.
My issue isn't necessarily with the technology, since trained readers using quality stereo photos can detect retinopathy about as well as a dilated fundus exam (the same point that your linked article makes). My question is what about the co-morbidity of these diabetic patients? Who's watching for cataracts, glaucoma, vessel occlusions, etc?
Sometimes I wonder if eye exams will be completely automated, and OMDs and ODs will end up like radiologists, reading telemedicine info in dark rooms. Even now, you could set up a mall kiosk with a wavefront autorefractor/topographer, Optos, OCT set for anterior seg, OCT of retina, GDx, non-mydriatic camera, FDT, and NCT, and make an argument that that constitutes a reasonably complete eye exam. In 10 years all the above equipment will probably be in no more than 2 or 3 machines, and the 'exam' would be even faster and more accurate.
You said you think that tele-medicine will change eye care. How far and fast do you think these changes will go?
Tom Stickel
Indiana U. 2001