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Teleoptometry: Contact lens consultation via the internet

1 December 1999


Introduction: Teleoptometry involves the transmission of digitized optometric information from a remote site for analysis by an expert. A new application of teleoptometry involves consultation on contact lens problem cases. The project reported here had two goals. The first was to assess the feasibility of electronically transmitting via the Internet digital information including video clips of dynamic flourescein patterns and lens movement, topographical maps of the cornea, and lens parameters to a remotely located expert for analysis. The second was to determine whether the electronic compression and transmission of these data would significantly affect the ability of expert to use them to analyze lens performance.

Methods: 30-sec samples of dynamic RGP lens fluorescein patterns, topographic corneal maps, and basic information on lens parameters were analyzed "live" by a contact lens expert and again by two experts after digitization and electronic compression. The experts were asked to determine whether lens performances were acceptable, and, if they were not, how the lens parameters should be changed.

Results: For the initial evaluator who observed the lenses live and from CD-ROM, there was agreement on whether the fit was acceptable versus unacceptable for 78.2% of the subject/fit combinations. After independently reviewing the digitized and compressed video and other data in the case folders, the two Evaluators agreed 78% of the time on whether or not the fit was acceptable or unacceptable.

Discussion: The agreement for the high majority of cases between evaluators and between live and compressed video observations suggest that teleoptometry for contact lens fit evaluations is feasible. When technology advances to the point at which large files can be sent quickly via the Internet, it is likely that the practice of sending video clips showing dynamic flourescein patterns, lens movements and other information between doctors, experts, and laboratory consultants located at sites remote from each other can become commonplace.


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