TeleWomens Health

1

Tele-Ophthalmology Improving Access to Eye Care
for All Albertans

• Matt Tennant BA, MD, FRCSC
• Teleophthalmology Services
• Assistant Clinical Professor
• Department of Ophthalmology
• University of Alberta

2
Tele-Ophthalmology

• Leading causes of blindness
• Barriers to eye care
• Tele-Ophthalmology
• Goals
• Clinical Validation
• Benefits
• Alberta Statistics
• Future Goals

Eye disease in Alberta Barriers to eye
care Tele-Ophthalmology Goals Clinical
Validation Benefits Alberta Statistics Future
Goals
3
Leading Causes of Blindness in Alberta

• Diabetes
• Macular degeneration
• Glaucoma
• Genetic eye diseases

4
Barriers to Eye Care in Alberta

• Geography
• Costs
• Travel
• Accommodation
• Lost wages
• Education

5
Incidence of Eye Examinations by an
Ophthalmologist within 3 years of Diagnosis of
Diabetes (1995 to 2001) in Alberta

6
Benefits of Screening and Treatment

• Regular eye screening can
• prevent blindness
• Laser reduces the risk of
• vision loss by 50
• Early treatment reduces
• the risk of blindness to
• less than 1

7
Tele-Ophthalmology

• Offers an additional alternative to a
  conventional eye
• examination by an eye care specialist.
• Improves access to eye care while reducing
  travel distance
• and costs.
• Reduces unnecessary referrals to tertiary care
  centres.
• Improves knowledge transfer by bringing trained
  educators
• directly into the smaller communities of
  Alberta.

8
Goals

• To emulate a comprehensive
• eye examination at a distance
• Medical history
• Visual acuity
• Intraocular pressure
• Stereoscopic retinal photography

9
Assessment versus Screening

• Assessment
• Enables diagnosis of treatable eye disease.
• Allows other eye diseases to be identified.
• Screening
• Identifies presence or absence of a single eye
  
• disease.

10
Clinical Validation

• Comparison to both clinical examination and
  stereoscopic slide film photography

11
Alberta Diabetes Tele-Ophthalmology

• First Nations Programs
• SLICK, ADWP
• Provincial Programs
• MDSI
• Regional Programs
• Aspen Tele-Ophthalmology
• Capital Health Tele-Ophthalmology

12
Adaptive Deployment

• SLICK, MDSI
• Utilize both mobile and fixed camera systems.
• Photographers travel or are trained within their
  own communities.
• ADWP, Capital Health, Aspen
• Utilize fixed camera systems within a hospital
  setting.
• Photographers are hospital based employees who
  cross-cover for Tele-Ophthalmology.

13
Diabetic Tele-Ophthalmology Stats

• 3368 Albertans assessed (6111 visits)
• 1172 tele-ophthalmology visits in 2007
• 137 referred for treatment (11.68)
• 72.75 of people assessed had no diabetic
• retinopathy
• 27.25 had some level of diabetic retinopathy

14
Future Goals

• Creation of a province wide registry for all
  people
• with diabetes.
• Improve access to eye care by creating a province
• wide tele-ophthalmology network.

15
Tele-Ophthalmology Improving Access to Eye Care
for All Albertans

• Matt Tennant BA, MD, FRCSC
• Teleophthalmology Services
• Assistant Clinical Professor
• Department of Ophthalmology
• University of Alberta