Teleophthalmology adoption and perceived barriers among Colombian general practitioners: a cross-sectional study

Telemedicine has improved access to healthcare, reduced costs, and minimized infection risks, particularly during the COVID-19 pandemic. Teleophthalmology may enhance access to eye care, but its adoption remains limited by barriers such as inadequate training and insufficient infrastructure.

To assess perceptions, self-reported ophthalmologic confidence, and perceived barriers related to teleophthalmology among Colombian general practitioners.

We conducted a cross-sectional online survey between February and May 2024 using a 31-question questionnaire covering demographics, prior training, telemedicine experiences, ophthalmologic confidence, and teleophthalmology perceptions. Composite Likert-based scores were categorized into three levels. Internal consistency was assessed using Cronbach's alpha, and associations were evaluated using chi-square tests and multivariable binary logistic regression.

Among 489 participants, most were women (62.2%), aged 21-30 years (70.1%), and had 0-5 years of professional experience (65.6%). Undergraduate telemedicine training was uncommon (9.0%), and prior teleophthalmology experience was rare (1.8%). Confidence in ophthalmologic knowledge was mostly moderate (45.6%), whereas 57.3% reported positive perceptions of teleophthalmology. In adjusted analyses, greater undergraduate ophthalmology training was independently associated with high ophthalmologic confidence, with a dose-response pattern, including 51-100 h (aOR: 8.82, 95% CI: 2.88-27.08) and >100 h (aOR: 14.71, 95% CI: 3.86-55.97). Prior experience providing telemedicine consultations was also associated with high confidence (aOR: 1.92, 95% CI: 1.16-3.18). Moderate ophthalmologic confidence was independently associated with positive teleophthalmology perception (aOR: 2.46, 95% CI: 1.60-3.80).

Colombian general practitioners showed generally favorable perceptions of teleophthalmology despite limited prior exposure and persistent concerns regarding privacy, workload, job security, training, and implementation readiness. Strengthening ophthalmology and telemedicine training, together with digital readiness, may support teleophthalmology integration into routine practice.