Strabismus examination by telemedicine.

Area of Science:

• Ophthalmology
• Medical Technology
• Telehealth

Background:

• Strabismus assessment traditionally relies on in-person examinations.
• The integration of telemedicine (TM) technology offers potential for remote patient evaluation.
• Evaluating the reliability of TM for strabismus assessment is crucial for its clinical adoption.

Purpose of the Study:

• To assess the reliability of strabismus evaluation using telemedicine technology.
• To compare the agreement between telemedicine and standard in-person examinations for strabismus.
• To identify specific parameters where telemedicine reliability may be limited.

Main Methods:

• Two prospective interobserver agreement studies were conducted.
• One study compared telemedicine (TM) versus standard examinations; the other compared two standard examinations.
• Strabismus patients over 4 years old were assessed using video teleconferencing equipment and standard methods.

Main Results:

• Good agreement was found for strabismus category (except vertical deviations) and angle of deviation (horizontal and vertical).
• Muscle action ratings showed high agreement (within one point) for most rectus muscles.
• Telemedicine examination demonstrated a twofold to threefold increased odds of disagreement compared to in-person assessment.

Conclusions:

• Telemedicine enables reliable strabismus assessment using video conferencing technology.
• Reliability is reduced for detecting small vertical deviations by inspection and evaluating oblique muscle actions.
• Telemedicine is a viable tool but requires careful consideration for specific strabismus parameters.