Virtual clinics in glaucoma care: face-to-face versus remote decision-making

Area of Science:

• Ophthalmology
• Telemedicine
• Clinical Decision-Making

Background:

• Glaucoma management requires accurate clinical decisions regarding patient status.
• Virtual clinics are emerging as a potential alternative to traditional face-to-face consultations.

Purpose of the Study:

• To assess the agreement between clinical decisions made in a virtual glaucoma clinic and those from face-to-face consultations.
• To evaluate the safety and viability of virtual glaucoma clinics.

Main Methods:

• Prospective data collection for 204 patients.
• Comparison of virtual review decisions with subsequent face-to-face assessments by glaucoma consultants.
• Calculation of interobserver and intraobserver agreement for virtual versus standard care.

Main Results:

• Adverse disagreement occurred in 3.4% of patients, with virtual review failing to predict accelerated follow-up needs in a few cases.
• Misclassification events were rare (1.9%).
• Interobserver agreement showed fair to moderate agreement (κ=0.24-0.41), and intraobserver agreement was fair (κ=0.26-0.27).

Conclusions:

• Virtual glaucoma clinics demonstrate a low rate of adverse misclassification.
• The findings suggest virtual clinics are a safe and logistically viable option for selected glaucoma patients.
• Regular reassessment supports the safety of virtual glaucoma care.