Australia’s rural and remote populations have chronic issues with eye healthcare access due to a maldistribution of the clinical workforce.1
However, OPSM has plans to make a difference by expanding its remote optometry services following a successful pilot program in 2023. The initiative, which leverages EssilorLuxottica’s cutting-edge technology, is enabling the provision of comprehensive eye exams to patients in underserved communities.
OPSM’s remote optometry model places patients in conveniently located practices, such as those served by visiting optometrists only. Guided by trained technicians, the new scheme allows optometrists to conduct examinations remotely. This approach has been fine-tuned through significant investments in local clinical protocols and a reimagined patient journey.
A Seamless Experience
The remote consultation process begins with obtaining patient consent,* followed by pre-test procedures conducted by a technician who provides all data to the optometrist for review prior to the consultation. Pre-testing includes a comprehensive measurement using the Wave Analyser Medica 800 (WAM800), encompassing autorefraction to 0.01D, low and high order aberration assessment, topography, pupillometry, retro-illumination of the crystalline lens, pachymetry, and tonometry. The technician proceeds to conduct an ultra-wide digital retinal scan capturing a 200º view of the retina, as well as optical coherence tomography (OCT) using the Revo fundus camera with the capability to perform axial length biometry.
The technician continues to play a pivotal role in the patient journey, accompanying the patient during the consultation, where a seamless connection allows the optometrist to remotely control and perform the eye examination. The Essilor VR800 refines refraction to 0.01D, with the optometrist remotely operating the phoropter and chart, and the option to choose from the patients’ existing prescription or autorefraction as the starting point.
A slit lamp examination is also performed using Essilor’s SL650. During the diagnosis and management discussion, the optometrist can present scans and results on screen, demonstrate any changes to prescription at the touch of a button, and present visualisations of common eye disorders.
If a referral is required, it can be done securely using the Oculo platform. Comprehensive triaging occurs to ensure any ocular emergencies are referred appropriately prior to consultation.
The technician continues to play a pivotal role in the patient journey, accompanying the patient during the consultation
Real World Setting
OPSM’s remote optometry model has been surprisingly successful for Tegan Hagley, an optical dispenser with OPSM in Kalgoorlie, who performs the role of a technician, guiding patients through the process.
“Our team was reticent about the idea when it was first introduced, but now we are the biggest advocates,” she told mivision.
With remote optometry, the Kalgoorlie practice has significantly expanded its capacity to look after the eyes of the local community.
Ms Hagley told the story of guiding a deaf patient through a remote eye examination. “She had never been comfortable having eye examinations, but she came in and I sat with her, signing and relaying the results of each test to the optometrist. At the end of the examination, she felt that this was her most thorough eye exam to date. Now she often drops into the practice to express her gratitude about this exceptional service.”
On a personal level, Ms Hagley said the opportunity to be involved with remote optometry has reignited her passion in the industry. “Having been an optical dispenser for 20 years, my work was becoming routine. Now I’m using my skills more, I’m learning about optometry and what goes on in the consultation room, using much of the equipment and imaging devices, and I love it,” she said.
Optometrist Ivy Han has been part of the pilot program since the beginning and at one stage was providing remote optometry five days a week.
“From my first day I was comfortable working with the technician, analysing scans, and working through results remotely with my patients.” Perhaps most importantly she said she “felt confident with the outcomes I was achieving”.
Ms Han said one of the most enjoyable aspects of providing remote optometry is the people she meets. “I have the opportunity to serve a different demographic to the patients
I look after in person in Sydney,” she observed. Another rewarding aspect is the ability to help communities that are incredibly grateful for the access to eye care through the remote optometry model.
Opportunities all Round
Following successful trials in South Hedland, Albany, and Kalgoorlie in 2023, OPSM plans to expand remote optometry availability across additional locations. This initiative is expected to play a crucial role in addressing the evolving needs of optometrists and patients in regional Australia.
*OPSM conducts the consultation without Medicare rebate.
Reference
1. Kiburg, K.V., Turner, A., He, M. Telemedicine and delivery of ophthalmic care in rural and remote communities: Drawing from Australian experience. Clin Exp Ophthalmol. 2022 Sep;50(7):793–800. doi: 10.1111/ceo.14147.
