Teleophthalmology is helping eye care reach large, under-served populations

The eastern train corridor is a lifeline that connects Northeast India, West Bengal and Orissa with the Southern States. Train travel along this route offers many scenic wonders, with the train track passing right on the edge of the 900 sq. km Chilka lake.

Another interesting observation as you travel southward on this route is that each train carries several passengers headed to eye hospitals in southern cities. India has nearly one-fourth of the world’s blind. Patients with severe complications, along with anxious relatives are a common sight, as they seek out the very highly regarded, often low-cost or no-cost eye hospitals in cities like Chennai and Hyderabad.

Environmental costs

But the cost and inconvenience of traveling from a rural area to an eye care specialist can be a major deterrent. A recent study published in the journal BMC Ophthalmology from the LV Prasad Eye Institute has shown that a village dweller must travel 80 km to get primary care. The travel to a tertiary care centre that offers advanced medical equipment and expertise is even more. Nearly half the patients coming to the LV Prasad Eye Institute come by train and travel an average of 1,666 km for the visit. The same holds true for Sankara Netralaya in Chennai and Aravind Eye Hospital in Madurai.

Besides the cost involved, all this travel adds up to a sizable carbon footprint. In India, the health care sector accounts for nearly 5% of the country’s carbon footprint, which is the amount of greenhouse gases, emitted directly or indirectly, by a sector. As we focus more and more on going green, and on reducing our emissions, telemedicine, in which you diagnose, treat, and monitor patients from afar, has been gaining ground.

Teleophthalmology

Eye care is beginning to reach large, under-served segments of the population with the use of teleophthalmology. One inherent advantage that teleophthalmology has is that imaging systems are at the heart of early detection and diagnosis of eye diseases, and for tracking the progression of such diseases. Most of these systems require taking photographs of the interior surface of the eye with specialised equipment. An eye specialist then carefully studies the images and makes a diagnosis.

For example, images of the retina, which lies at the back of the eye, can be captured using fundus photography, which aids in the detection of conditions such as glaucoma and diabetic retinopathy. Similarly, Optical Coherence Tomography generates images that reveal details of the layers of the retina and is particularly useful for monitoring conditions such as retinal detachments.

New developments in such devices are leading to their downsizing. In some cases, they become attachments to the cameras on mobile phones. This will make them easy to use in primary centres that are located close to rural populations. Advances in other technologies, such as the availability of 5G services will greatly improve the reliability of communication between patients and their remote specialists.

Telemedicine has made an impact in many other areas of medical care. Wearable devices, of which smartwatches are the most visible, can be set up to continuously relay data such as heart rate and blood pressure to cardiac care providers, who monitor them for anomalies.

So, the next time you suspect that a family member has conjunctivitis, you may be able to confirm, or allay your fears by means of a remote consultation!

(The article was written in collaboration with Sushil Chandani, who works in molecular modelling)