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

Abstract

Objective

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.

Design

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.

Setting

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

Participants

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.

Results

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.

Conclusions

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.