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      The Mobile Teleophthalmology Unit in Rural and Underserved Areas of South India

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          Our objective was to provide an eye care service to rural and underserved areas in Chennai, Kanchipuram, and Thiruvallur districts of Tamil Nadu, South India.


          We conducted eye camps to provide ophthalmic services to the underserved and rural areas, where people cannot afford to go to a hospital due to lack of accessibility, lack of awareness, or financial constraints.


          The study was conducted in rural and underserved areas of Thiruvallur, Chennai, and Kanchipuram districts from January 2015 to December 2019.


          Patients ( N = 1,05,827) underwent comprehensive eye examination in eye camps with the state-of-art ophthalmic equipment.

          Main outcome measures

          To report on the number of patients examined, number of eye disorders screened, and different types of ocular pathology screened, all clinical findings were recorded and all ocular images were uploaded in the electronic medical records. All patients with ocular diseases underwent teleconsultation with an ophthalmologist at the base hospital with internet connectivity. Video conferencing and teleconsultation were feasible only in areas with good internet connectivity.


          Over the 5-year study period, 1,05,827 patients underwent eye evaluation at 1,061 eye camps. Among these, 48,354 (45.7%) patients were males, 57,473 (54.3%) patients were females, 15,515 patients were emmetropes. The most common cause of avoidable blindness was uncorrected refractive error detected in 66,137 eyes, referable cataract was seen in 13,536 eyes, 2,491 eyes were identified to have retinal diseases, and there were 789 patients with only diabetic retinopathy, thus totaling to 3,280 comprising of all retinal disease. 2424 patients received teleconsultations. For further investigations and treatment, which were provided free of cost, patients were referred to the base hospital in Chennai. There were 6,309 patients who received free spectacles and an additional 31,192 patients received spectacles at a low cost; 13,536 patients had referable cataract and were referred to the base hospital for further evaluation and surgery.


          Teleophthalmology holds great potential to overcome barriers, improve quality, access, and affordability to eye care, and has proven to be an innovative means of taking comprehensive eye care facilities to the doorsteps of rural India.

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          Most cited references 14

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          Global estimates of visual impairment: 2010.

          From the most recent data the magnitude of visual impairment and its causes in 2010 have been estimated, globally and by WHO region. The definitions of visual impairment are the current definitions of presenting vision in the International Classification of Diseases version 10. A systematic review was conducted of published and unpublished surveys from 2000 to the present. For countries without data on visual impairment, estimates were based on newly developed imputation methods that took into account country economic status as proxy. Surveys from 39 countries satisfied the inclusion criteria for this study. Globally, the number of people of all ages visually impaired is estimated to be 285 million, of whom 39 million are blind, with uncertainties of 10-20%. People 50 years and older represent 65% and 82% of visually impaired and blind, respectively. The major causes of visual impairment are uncorrected refractive errors (43%) followed by cataract (33%); the first cause of blindness is cataract (51%). This study indicates that visual impairment in 2010 is a major health issue that is unequally distributed among the WHO regions; the preventable causes are as high as 80% of the total global burden.
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            Diabetic retinopathy screening and the use of telemedicine.

            Evidence-based practice guidelines and treatments are highly effective in reducing vision loss from diabetic retinopathy. However, less than half of the total number of patients with diabetes mellitus receive recommended annual retinal evaluations, and vision loss due to diabetic retinopathy remains the leading cause of blindness in adults. Poor adherence to screening recommendations stems from a number of challenges which telemedicine technology may address to increase the evaluation rates and ultimately reduce vision loss. The aim of this review was to provide an update on the recent advances in tele-ophthalmology and how it may expand our current concept of eye care delivery for diabetic eye disease.
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              Comparing the effectiveness of telemedicine and traditional surveillance in providing diabetic retinopathy screening examinations: a randomized controlled trial.

              To determine the effectiveness of telemedicine for providing diabetic retinopathy screening examinations compared with the effectiveness of traditional surveillance in community health clinics with a high proportion of minorities, including American Indian/Alaska Natives.

                Author and article information

                Telehealth and Medicine Today
                Open Academia
                23 April 2021
                : 6
                [1 ]Department of Teleophthalmology, Sankara Nethralaya, Chennai, India
                [2 ]Vision Research Foundation, Chennai, India
                Author notes
                [* ]Correspondence: Sheila John. Email: sheilajohn24@ 123456gmail.com
                © 2021 The Authors

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

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