Clinical Scorecard: Remote Optometry Delivers, But Challenges Remain

At a Glance

Key Highlights

• 24% of U.S. counties lack eyecare providers, with rural areas significantly underserved.
• Teleretinal exams reduced screening wait times from 158 days to 17 days.
• 99% of patients in a VA program were seen within 14 days of contact.
• Challenges include referral completion and professional tensions between remote and onsite providers.
• Standardization of protocols and training for remote optometrists is necessary.

Guideline-Based Recommendations

Diagnosis

• Identify appropriate patients for remote examinations.
• Avoid forcing patients into unsuitable examination modalities.

Management

• Implement navigators and integrated scheduling to improve referral completion.
• Support remote optometrists with access to real-time consultations.

Monitoring & Follow-up

• Measure quality of care beyond volume-based metrics.

Risks

• Professional tensions may affect continuity of care.
• Inconsistent experiences across different remote platforms.

Patient & Prescribing Data

Patients in rural and underserved areas requiring eye care.

Remote care can increase patient access but requires effective referral systems.

Clinical Best Practices

• Standardize clinical protocols across remote platforms.
• Conduct frequent and consistent training for technicians and onsite staff.
• Ensure clinical autonomy for remote providers.

Related Resources & Content

• Gibson DM. The geographic distribution of eye care providers in the United States: implications for a national strategy to improve vision health.
• Soares RR, Mokhashi N, Sharpe J, et al. Patient accessibility to eye care in the United States.
• Berkowitz ST, Finn AP, Parikh R, Kuriyan AE, Patel S. Ophthalmology workforce projections in the United States, 2020 to 2035.
• Daskivich LP, Vasquez C, Martinez C Jr, Tseng CH, Mangione CM. Implementation and evaluation of a large-scale teleretinal diabetic retinopathy screening program in the Los Angeles County Department of Health Services.
• Maa AY, Wojciechowski B, Hunt KJ, et al. Early experience with Technology-Based Eye Care Services (TECS): a novel ophthalmologic telemedicine initiative.