The Advantages of a Tele-Optometry Eye Exam
An estimated 200 million Americans require vision correction. The most common issue seen recently is that the majority of these people, especially adults, think nothing of eye disease symptoms until it’s too late. This results in an increased risk of vision loss – a risk that approximately 61 million American adults face.
Mitigation of this risk is simple: eye exams annually or every two years. The reality is that, of the 61 million at-risk adults, only half saw an optometrist or ophthalmologist for an assessment of their eye health.
The biggest advantage of tele-optometry is its resolution of the problem it aims to address: accessibility. Several of the contributing factors in the refusal to see an optometrist include lack of time and failure to get an appointment. But even if these factors are present, most patients show an eagerness for an eye exam if you remove accessibility constraints. These constraints may come in the form of the optometrist’s office location, the office’s distance from the patient’s home, and the amount of time it takes to travel to and from the optometrist’s office. Most of the time, the optometrist’s office can either be on the far side of town or in another town altogether.
Access to specialized health care services is still a big issue in small and remote communities. Hospitals and other health care facilities in rural areas have trouble hiring and keeping specialist doctors. There are over 7,000 areas in the US that currently experience health care professional shortages. Approximately 60 percent of these are rural areas.
Imagine traveling for hours to access critical care or manage chronic illnesses. An eye exam definitely looks trivial in comparison. For people in these areas, an eye exam would mean a day of missed work or school and a considerable amount spent on gas or public transport. Most of the time, it will take anywhere from an hour to two weeks to fill an eyeglass prescription depending on the availability of the lenses and the complexity of the prescription.
Tele-optometry aims to remove major barriers in accessibility, bridging the gap in service delivery by enabling optometrists to reach patients from remote and/or underserved areas. Optometrists and health care institutions can include remote screening capabilities in their equipment and set up walk-in eye exam facilities in multiple locations.
In short, tele-optometry removes the need for an appointment with an optometrist and adjusting your schedule around said appointment. You can walk-in to a participating location at your convenience.
The bigger picture is that tele-optometry offers a solid solution to the ongoing issue of a health care professional shortage. It allows patients to access necessary vision interventions and advanced diagnostic tools, that can reduce the overall healthcare cost.
Refractive Vs. Comprehensive Eye Exam
During in-person eye exams, refraction tests are the norm. Unfortunately, this test only determines the patient’s eyeglass or contact lens prescription. This type of vision examination is the most popular service among tele-optometry companies and optometric practices alike. Because of the limited scope of examination, refraction tests don’t/can’t detect retinal problems, diabetes, glaucoma or even signs of astigmatism. Therefore, this type of exam cannot provide information on the overall health of the patient’s eyes, only necessary information for correcting the patient’s eyesight.
A comprehensive eye exam, on the other hand, screens for up to 10 data points collected from test components that may include:
- Assessment of general medical history including disease predisposition, existing medical conditions, and medications currently being taken.
- Visual health history. This history covers eye diseases that run in the family, previous eye injuries and treatments, date of the latest eye exam, and recent changes in vision.
- External eye examination. The optometrist will first assess the visible parts of the eyes including the eyelids, iris, pupil, and sclera followed by a non-dilated fundus exam to examine the optic nerve and retina. The final part of the external examination is the fluid pressure test or tonometry test to detect signs of glaucoma.
- Refraction test. Also called visual acuity testing, refraction involves the use of a phoropter, an equipment that tests the patient’s vision with the use of different types of lenses. It mainly measures astigmatism and analyzes binocular vision to determine if it can be corrected with eyeglasses or contact lenses.
- Peripheral or visual field testing. This test component assesses your visual field, especially the peripheral vision. The optometrist may manually perform a confrontation field test wherein they will flash his fingers on each side of your visual field or use a computerized visual field analyzer. A considerable loss in peripheral vision is another sign of glaucoma.
Aside from glaucoma, comprehensive eye exams can also detect eye floaters, cataracts, diabetic retinopathy, and macular degeneration, to name a few.
Remote comprehensive eye exams use the standard procedure as stated above. The major difference is the addition of digital communication, online connectivity, and remotely-controlled equipment to further enhance the efficiency and accuracy of test result readings regardless of the optometrist’s location.
DigitalOptometrics Tele-Optometry Eye Exams
Videoconferencing is probably one of the first things that come into mind at the mention of telemedicine. The development of high-definition cameras and videoconferencing capabilities enabled telemedicine to grow by leaps and bounds. But there is more to tele-optometry than meet the eyes.
The development of DigitalOptometrics’ tele-optometry system is the fruit of two years of collective efforts from Dr. Howard Fried and his team. The system runs on an advanced proprietary optical software that enables licensed optometrists to perform eye exams remotely through remotely-operated optometric equipment integrated into a secured network for a seamless process from patient data gathering to the writing of prescriptions. With high-definition live videoconferencing capabilities tele-optometry by DigitalOptometrics can provide not only comprehensive but also complete eye exams within 30 minutes.
This optical system is unique from other systems in the tele-optometry industry as it seamlessly integrates to existing optometric tools. Optometric institutions can serve as a tele-optometry host provider, either equipping optometric practices within their network with DigitalOptometric’s optical system or avail of DigitalOptometric’s network of state-licensed optometrists.
The optometrist also has full control of the optical system, enabling him/her to perform subjective refraction and thorough visual analysis, engage with the patient in real-time with voice and video conferencing, and to turn off the system’s remote connection capabilities. The latter feature will allow optometrists to use the optical system for on-site eye exams.
The Tele-Optometry Eye Exam Process
Patient Information and History
The DigitalOptometrics tele-optometry eye exam process begins with the Tablet Kiosk-Patient Experience. Patients enter required information, by answering questions regarding the following:
- Insurance coverage
- Medical history
- Existing eye problems (dry eyes, glare or halos, etc.)
- Medications you are taking (both prescription and over-the-counter)
The next step is the visual prescreening, a process that will be performed by an ophthalmic technician. Visual pre-screening involves different types of tests including:
- Autorefraction (with the use of an autorefractor-keratometer to determine your eyeglass/contact lens prescription)
- Non-contact tonometry (with a tonometer to measure eye pressure and detect signs of glaucoma)
- Retinal imaging (with a fundus camera to map out and magnify the ocular fundus and vitreous)
- Anterior Segment video (with a slit lamp to look at the structures at the front of the eye including cornea, conjunctiva, lens, lid margin, etc.)
- Lensometry (with an auto-lensometer determine the prism, cylinder, sphere, and axis of patient glasses with unknown prescription)
These tests aim to produce clear and high definition images of the eyes that can help the optometrist create a precise prescription.
After a series of pre-screening tests, the patient then proceeds to the exam lane for remote subjective refraction. An ophthalmic technician will appear onscreen via high-definition videoconferencing and perform the refraction in real-time with the help of DigitalOptometrics’ proprietary optical system. This is a full subjective refraction conducted by a trained technician with a remotely-controlled phoropter.
The ophthalmic technician will guide you through the process and will provide prompts and instructions throughout the exam.
Exam Result Review and Analysis via Video Conferencing
All test results are entered into the system and saved on a secure cloud database. The optometrist can easily pull patient history and eye exam results from their record on the database. Within a few minutes after the exam, the optometrist will review both the patient’s medical history and test results, and discuss their findings with the patient via high-definition videoconferencing. This ensures that the patient can have the same patient-physician interactions with the remotely-located optometrist.
The optometrist may require further refraction refinements by remotely operating the phoropter.
Writing of Prescription and/or Specialist Referral
After making recommendations and/or diagnosis, and answering the patient’s questions, the optometrist will write a new prescription. A specialist referral may be necessary if the results show signs of eye conditions that need treatment. The optometrist may refer the patient to other optometrists that specialize in specific conditions like diabetes, macular degeneration, or glaucoma among others. There are also conditions that need attention from your primary care physician or ophthalmologist.
The referral process is straightforward with the help of DigitalOptometric’s optical system. The optometrist can select the referral tab on the system’s interface. The optometrist can select from the specialists available on the list or from a pre-selected list of specialists.
Just over a year after its launch, DigitalOptometrics’ optical system has completed over 20,000 exams and anticipates having 150 locations implemented by the end of 2019.
Common Misconceptions About Tele-Optometry
Tele-optometry is a new technology, especially in a commercial context. But in the short time that tele-optometry had been in existence, there had been misconceptions and confusion on the different aspects of optical telemedicine.
These misconceptions often stem from misconceptions, misunderstanding about the differences in tele-optometry systems and overall lack of information about its benefits and advantages. Here are three of the most common misconceptions about tele-optometry:
Tele-optometry eye exams are more expensive.
This misconception may come from the belief that the cost of optical systems, like that of DigitalOptometrics, will be passed on to the patients. In reality, optometrists and health care institutions can actually save a considerable amount of money by providing comprehensive eye exams at multiple locations with one remotely based optometrist.
Insurance companies won’t cover tele-optometry eye exams.
Insurance coverage for telemedicine, in general, varies from state to state. For Medicaid, 48 states cover synchronous telemedicine or telemedicine that involves live videoconferencing (with location limitations). Medicare only covers telemedicine services for patients in rural and underserved areas among other criteria.
This does not reflect private insurance coverage, though. Several insurance carriers do cover specific telemedicine services but coverage varies from state to state. Tele-optometry will fall under vision coverage in your insurance policy. There are also vision insurance benefits plans that will cover most of the prescription’s cost and vision coverage by most insurance companies is evolving.
Tele-optometry eye exam results aren’t as accurate as in-person exams.
Even before the tele-optometry’s rise in popularity, various government and academic institutions already acknowledged the potential of optical telemedicine solutions in order to provide critical patient diagnosis, efficient and convenient patient monitoring, and overall improvement of the patient experience. So, to say that tele-optometry solutions are, in general, unreliable is untrue.
Though several tele-optometry solutions earned criticisms from experts, newer systems, such as DigitalOptimetrics’ are able to prove that utilizing advancements in technology help improve the efficiency of optometric and ophthalmic tools and replicate a comprehensive on-site in-person exam with a remotely-based optometrist.
To learn more about the advantages that you can receive from Tele-optometry by DigitalOptometrics, contact us at (877) 506-0002 or email info@Digitaloptometrics.com.