@article {1629469,
	title = {Effectiveness of a telemedicine program for triage and diagnosis of emergent ophthalmic conditions},
	journal = {Eye (Lond)},
	volume = {37},
	number = {2},
	year = {2023},
	month = {2023 Feb},
	pages = {325-331},
	abstract = {BACKGROUND: To study the utility of a teleophthalmology program to diagnose and triage common ophthalmic complaints presenting to an ophthalmic emergency room. METHODS: Prospective, observational study of 258 eyes of 129 patients presenting to the Massachusetts Eye and Ear Infirmary Emergency Ward (MEE EW) who completed a questionnaire to gather chief complaint (CC), history of present illness, and medical history. Anterior and posterior segment photographs were collected via iPhone 5 C camera and a Canon non-mydriatic fundus camera, respectively. Ophthalmic vital signs were collected. All information was reviewed remotely by three ophthalmologists; a diagnosis and urgency designation were recorded. The remote assessment was compared to gold standard in-person assessment. RESULTS: The 129 recruited patients collectively contributed 220 visual complaints, of which 121 (55\%) were from females with mean age 56.5 years (range 24-89). Sensitivities and specificities for telemedical triage were as follows: eye pain (n = 56; sensitivity: 0.58, CI [0.41, 0.74]; specificity: 0.91, CI [0.80, 1]), eye redness (n = 54; 0.68, CI [0.50, 0.86]; 0.93, CI [0.84, 1]), blurry vision (n = 68; 0.73, CI [0.60, 0.86]; 0.91, CI [0.80, 1]), and eyelid complaints (n = 42; 0.67, CI [0.43, 0.91]; 0.96, CI [0.89, 1]). The remote diagnostic accuracies, as stratified by CC, were eye pain (27/56; 48.21\%), eye redness: (32/54; 59.26\%), blurry vision: (30/68; 44.11\%), eyelid (24/42; 57.14\%). CONCLUSIONS: Telemedical examination of emergent ophthalmic complaints consisting of a patient questionnaire, anterior segment and fundus photos, and ophthalmic vital signs, may be useful to reliably triage eye disease based on presenting complaint.},
	keywords = {Adult, Aged, Aged, 80 and over, Eye Pain, Female, Fundus Oculi, Humans, Middle Aged, Ophthalmology, Prospective Studies, Telemedicine, Triage, Vision Disorders, Young Adult},
	issn = {1476-5454},
	doi = {10.1038/s41433-022-01940-8},
	author = {Meshkin, Ryan S and Armstrong, Grayson W and Hall, Nathan E and Rossin, Elizabeth J and Hymowitz, Maggie B and Lorch, Alice C}
}
