Teleophthalmology in the evaluation of ocular trauma

Objective: The objective of this investigation is to evaluate the efficacy of teleophthalmology in the assessment of anterior segment and ocular adnexal trauma using digital imaging devices. Methods: Eight ocular injuries were created in an animal model. Two separate photographers of different skill levels photographed each injury using four different cameras. The images were transmitted via the Internet and were reviewed by 83 ophthalmologists masked as to the injury, camera, and photographer. The ability to make the correct diagnosis was evaluated. Results: The correct diagnoses were made most consistently for the full-thickness eyelid laceration (96%), corneoscleral laceration with uveal prolapse (92%), partial-thickness eyelid laceration (86%), and hyphema (80%). The correct diagnoses were made less frequently with the intraocular foreign body (10%), normal eye (39%), and corneal foreign body (46%). Conclusions: With the current technology, it appears that teleophthalmology can be used with some reliability to assist with the diagnosis of certain ocular injuries. However, improvements in technology will be necessary before the diagnosis of most intraocular injuries will be able to be done on a consistent basis.