Objective:
To discuss the benefits and challenges of remote optometry as presented by Dr. Molly King at the 2026 meeting of the American Academy of Optometry, emphasizing the impact of geography on care accessibility.
Approach:
- Geographic Impact on Care: Dr. King highlighted that 24% of U.S. counties lack eyecare providers, with rural areas facing significantly worse accessibility.
- Teleretinal Exams: Implementation of teleretinal exams in LA County reduced screening wait times from 158 days to 17 days, identifying many patients who did not require referrals.
- TECS Program: The Atlanta VA's TECS program improved patient access and reduced wait times while maintaining high agreement between telemedicine and in-person evaluations.
- Remote Care Challenges: Dr. King noted the need for closed-loop referral systems and the importance of reducing friction between remote and onsite providers.
- Clinical Appropriateness: Not all exams are suitable for remote platforms; certain cases require in-person evaluations.
- Standardization and Training: Advocacy for standardized protocols and ongoing training for remote optometrists was emphasized.
Key Findings:
- Rural counties have 2.47 times the odds of being in the worst quartile for eye care accessibility compared to nonrural areas.
- By 2035, nonmetro areas are projected to have only 29% workforce adequacy for eye care.
- Implementation of teleretinal exams significantly reduced wait times and improved patient access.
- Completion rates for referrals improve with navigators and integrated scheduling.
Interpretation:
Remote optometry increases patient access but faces challenges in referral completion and provider collaboration.
Limitations:
- Not all eye exams are suitable for remote platforms, as certain cases require in-person evaluations.
- There are inconsistent experiences across different remote platforms.
Conclusion:
Dr. King emphasized that remote optometry should enhance patient care without compromising clinical standards.
Sources:
- Gibson DM. The geographic distribution of eye care providers in the United States.
- Soares RR et al. Patient accessibility to eye care in the United States.
- Berkowitz ST et al. Ophthalmology workforce projections in the United States.
- Daskivich LP et al. Implementation and evaluation of a large-scale teleretinal diabetic retinopathy screening program.
- Maa AY et al. Early experience with Technology-Based Eye Care Services (TECS).
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