Telemedicine

Telemedicine in its broadest definition is the assessment and review of patient information (history, examination, or investigations) by a health professional who is separated temporally and/or spatially from the patient. In a sense this has always occurred with colleagues discussing difficult cases when they meet or over the telephone. Carrying x ray films to meetings would constitute a form of telemedicine under this broad umbrella. As such, telemedicine did not particularly constitute a subject for research or special interest. With the advance of technology, however, it has become possible to capture and store or transmit an ever increasing amount of information in the form of clinical records, sound, static images, and moving images. As the opportunities for information transfer are opening, so uses are emerging. We are still in an enormous state of flux with respect to telemedicine. The literature contains a large number of pilot ideas or projects from vastly disparate specialties exploring disparate uses. Another use that does not fully fit within the above framework is medical education. This major additional use will also be included for the purposes of this review.

Ophthalmology is a specialty that relies heavily on images for the diagnosis and management of the majority of ailments. It is not surprising that a considerable number of ophthalmologists have therefore been exploring telemedicine with enthusiasm, particularly as technology increasingly offers us the quality of information transfer we require to make safe and reliable clinical decisions. This article seeks to present an overview of telemedicine for ophthalmologists, and to present some important facets of the subject that need consideration as we adapt our medical practice to encompass the present technological revolution.