Posters

Teleophthalmology in a university hospital: the interdisciplinary work experience among university students, ophthalmologists, and other hospital doctors

Poster Details

First Author: P.Kern BRAZIL

Co Author(s):    R. Menna Barreto   V. Menna Barreto   R. Bruno   L. Pellanda   E. Neto   M. Vilela     

Abstract Details

Purpose:

At Santa Casa de Misericórdia hospital in Porto Alegre, it was identified that many outpatient and inpatient patients required eye examination, but the demand was not met by the institution's physicians. The purpose of our initiative, aiming for a better efficiency of care, was to elaborate a method that would allow the accomplishment of ophthalmologic examination and image collection by university students for a remotely ophthalmologic evaluation by the ophthalmology teachers. In addition to that, discussions of the collected clinical cases were created in open classes, and all the material was provided on the university website.

Setting:

Irmandade Santa Casa de Misericórdia de Porto Alegre Hospital, Porto Alegre, Brazil.

Methods:

Since 2016, nephrology, neurology, endocrinology and cardiology teachers have requested smartphone ophthalmologic evaluations to a group of students previously trained by an ophthalmologist. The students performed anamnesis and exams (visual acuity, pupillary reflexes, external ocular motricity and fundoscopy). The pupil reflexes were filmed and the fundus examination was performed with the aid of a 20 diopter lens and a smartphone. All the results were sent to an ophthalmologist teacher, who sent to the students and the requesting doctors the probable diagnosis and management. The students presented the cases in extraclass classes and made the material available on the university's website.

Results:

140 patients were evaluated between February 2016 and February 2018, 90 men (64%) and 50 women (35%). 82 patients (58.57%) presented fundus abnormalities, being diabetic retinopathy (42%), hypertensive retinopathy (35%), toxoplasmosis (6%) and optic neuritis (3%) the most prevalent. In the emergency, a case of retinal ischemia was diagnosed by the method, which aided in the final diagnosis and early management of Rhino-Orbital Mucormycosis (a predominantly fatal disease) and, in this case, resulted in successful therapy. There were 12 case discussion classes, which were attended by 115 different students. The site containing the clinical cases received 1113 accesses.

Conclusions:

The image quality was good and allowed the detection of ocular abnormalities. The method brought benefits to both the patients and health service, because it has a reduced cost when compared to ophthalmological equipment and reduces the waiting for medical care. Telemedicine in ophthalmology can help to screen for a great variety of diseases and promote the health of underserved populations living in places with scarce numbers of physicians. Furthermore, initiatives such as the one held at this brazilian hospital help educate students and encourage them to implement eye examination routinely, regardless of which medical specialty they choose to follow.

Financial Disclosure:

None