47:, health care professionals and researchers to carry out the aforementioned applications. The required equipment includes a camera that can take ocular images and a computer terminal with network capabilities, which can transfer the images. There has been a significant increase in teleophthalmology research over the past decade. However, differences in health information exchange standards, data security, liability issues, and cost of equipment are other major challenges in teleophthalmology.
25:
592:
swifter care of urgent cases. The project was led by
Consultant Ophthalmologist Simon P Kelly, Royal Bolton Hospital and Ian Wallwork, Optometrist, and undertaken in Salford. The project was recognized in an award from the Clinical Leaders Network. In Scotland, NHS Forth Valley has introduced teleophthalmology in standard practice, to link ophthalmologists and emergency services. The technology has been developed in collaboration with the
203:) may be required to obtain an image of sufficient quality. Stereoscopy may be used to detect retinal thickening. The image can then be transferred, over the Internet or dedicated network to a physician for immediate examination, or for storage and later review. Ideally, the image is encrypted or anonymized for transmission, to protect patient confidentiality. Between image capture and viewing, image processing may be done, including
116:
17:
551:, started in 2008, uses teleophthalmology to screen for retinopathy of prematurity. They are India's first, and the world's largest, program of this kind. They have performed more than 6339 imaging sessions of 1601 infants in rural and remote areas, preventing blindness and finding that non-physician experts can be trained to accurately grade the images.
604:
The United States
Department of Veterans Health Affairs was one of the first organizations to deploy a large-scale teleretinal imaging program starting in 1999. In 2006, this program was expanded and received further funding for a nationwide program. As of 2010, more than 120,000 patients have been
338:
Key challenges to providing teleophthalmology services in Canada are likely: 1) the high staff turnover in remote areas; 2) the lack of an inexpensive mobile imaging device that takes diagnostic quality images; and 3) the difficulty securing public funds where the costs are incurred and savings are
55:
Although ocular photography has been present since the early 1980s, the transfer of digital images from one location to another for assessment is a relatively recent phenomenon. The rise of digital imaging in the early 1990s allowed ophthalmologists and optometrists to capture images and store them
591:
In the United
Kingdom, more than 1.7 million people with diabetes were screened using digital fundus photography in 2010 and 2011. A pilot project with telemedicine transmission of retinal OCT images from community optometry care to hospital eye services improved the triage of macular patients and
90:
Mobile applications are widely available in ophthalmology and optometry as tools for eye tests (visual acuity, colour test, and viewing eye images) and for educational purposes. Technological advancements in digital ocular imaging devices are perceived by many as key drivers for teleophthalmology.
658:. Teleophthalmology has the potential to improve access to screening and early treatment for a number of ocular conditions. It serves to identify patients who are at risk of various types of retinopathy and allows further evaluation and early management resulting in considerable economic benefit.
363:
review the images. As of
January 2014, approximately 15,000 patients had been screened for diabetic retinopathy, across 15 community-hospital-based stationary locations, 44 First Nations communities and five primary care practices. Approximately 130 patients are screened per month across these
231:
Computer software applications have been tasked with the automated assessment of retinal images to recognize lesions associated with an ocular disease of interest. The clinical process entails initially discriminating retinal lesions from non-factor artifacts, subsequently distinguishing lesions
665:
notes that no randomized controlled trials or controlled clinical trials have been published evaluating whether there are any benefits or harms to telerehabilitation, over inpatient care for improving vision outcomes. The authors note that the lack of published research in teleopthalmology may
674:
Despite ongoing research and advancement in digital photography, digital imaging techniques still face certain barriers, including low sensitivity and specificity, as well as lack of stereopsis (impression of depth). As such, teleophthalmology cannot be a true substitute for comprehensive eye
479:
imaging devices, and all programs dilate their patients' eyes before screening. Since 2009, and as of
January 2014, more than 4600 diabetic patients have been screened, finding pathology in approximately 25-35% of screens. Approximately 120 patients are screened per month, by five reading
39:
that delivers eye care through digital medical equipment and telecommunications technology. Today, applications of teleophthalmology encompass access to eye specialists for patients in remote areas, ophthalmic disease screening, diagnosis and monitoring; as well as distant learning.
650:
Emerging techniques for eye image capture include ophthalmoscopes that can be combined with mobile devices, increasing portability and accessibility to the general public. The introduction of full auto focusing retinal cameras has the potential to reduce the need for operators.
420:
A teleophthalmology program was started in the
Eastern Health Region of Newfoundland, under one of four regional health authorities. This program was started in May 2012 and is supported by an ophthalmologist in St. John's. The program uses Synergy software by
1292:
Bhargava, M; C Y Cheung; C Sabanayagam; R Kawasaki; C A Harper; E L Lamoureux; W L Chow; A Ee; H Hamzah; M Ho; W Wong; T Y Wong (November 2012). "Accuracy of diabetic retinopathy screening by trained non-physician graders using non-mydriatic fundus camera".
678:
Automated image recognition algorithms are gaining in clinical adoption. While they perform at a level nearly equivalent to humans in ascertaining low and high risk states, diagnosis and grading performance is still insufficient for clinical acceptance.
334:
The cost of taking the images and of the ophthalmologist to interpret the images is covered by public-funded health care insurance. Typically a registered nurse or registered practical nurse is trained to dilate the patient's pupils and take the images.
95:
are capable of producing digital images of the retina with a micrometer resolution, which can be transmitted for research or diagnostic purposes. Along with systems designed for health care professionals, patient-centred systems such as
455:
The other eleven of these teleophthalmology programs primarily screen for diabetic retinopathy in diabetic patients who have limited access to eye care professionals, or who for various reasons do not seek regular eye care.
1482:
Li, Zhijian; Chengqing Wu; J Nwando
Olayiwola; Daniel St Hilaire; John J Huang (February 2012). "Telemedicine-based digital retinal imaging vs standard ophthalmologic evaluation for the assessment of diabetic retinopathy".
1240:
Patton, Niall; Tariq M. Aslam; Thomas MacGillivray; Ian J. Deary; Baljean
Dhillon; Robert H. Eikelboom; Kanagasingam Yogesan; Ian J. Constable (January 2006). "Retinal image analysis: Concepts, applications and potential".
1536:
Xu, Liang; Jost B. Jonas; Tong Tong Cui; Qi Sheng You; Ya Xing Wang; Hua Yang; Jian Jun Li; Wen Bin Wei; Qing Feng Liang; Shuang Wang; Xiao Hui Yang; Li Zhang (June 2012). "Beijing Eye Public Health Care
Project".
1638:"The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting"
148:
enables real-time interaction between participants (using standard telemedicine technologies e.g. video-conferencing), synchronous to supervise the removal of corneal foreign bodies and for consultations.
281:
Community nurses, ophthalmologists or optometrists in training can attend teaching sessions at the main hospital via a live video teleopthamological feed, thereby enhancing their knowledge and skills.
1899:
487:
In
Ontario, the implementation of teleophthalmology has reduced the average wait time from six months to four weeks, for some diabetic patients to obtain retinal screening from a specialist.
505:
1433:
Tobin, Kenneth W.; Abdelrahman, Mohamed; Chaum, Edward; Govindasamy, V. Priya; Karnowski, Thomas P. (2007). "A Probabilistic Framework for Content-Based Diagnosis of Retinal Disease".
1382:
Chaum, Edward; Thomas P. Karnowski; V Priya Govindasamy; Mohamed Abdelrahman; Kenneth W. Tobin (November 2008). "Automated Diagnosis of Retinopathy by Content-Based Image Retrieval".
79:, congenital anomalies, and tapetoretinal abitrophy. Several population-based studies have used retinal imaging to relate ophthalmic abnormalities to general conditions, including
44:
232:
associated with the disease in question from other types of lesions, and finally grading the disease according to guideline-endorsed severity scales set by medical authorities.
1716:
1587:
1738:
Abramoff, Michael D.; Maria S.A. Suttorp-Schulten (December 2005). "Web-Based Screening for Diabetic Retinopathy in a Primary Care Population: The EyeCheck Project".
1691:
613:
Teleophthalmology relies on a standard for the representation, storage, and transmission of medical images known as Digital Imaging and Communications in Medicine (
731:
Boucher, Marie C; Quyn T Nguyen; Karine Angioi (December 2005). "Mass community screening for diabetic retinopathy using a nonmydriatic camera with telemedicine".
43:
Teleophthalmology enables health professionals to take ocular images and attend to patients who have limited access to ocular health care. These images allow the
1082:
Hall, Geoffrey; Michael Hennessy; Joanna Barton; Minas Coroneo (February 2005). "Teleophthalmology-assisted corneal foreign body removal in a rural hospital".
1977:
Hooper, Philip; Marie Carole Boucher; Alan Cruess; Keith G Dawson; Walter Delpero; Mark Greve; Vladimir Kozousek; Wai-Ching Lam; et al. (April 2012).
2244:
629:
1800:
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on computers for future assessment. The advent of the Internet allowed for the digital transfer of these ocular images from one location to another.
632:- licensure laws in the U.S. require a practitioner to obtain a full license to deliver telemedicine care across state lines where regulations vary.
158:
Images of the eye can be captured non-invasively through various methods, generally by a technician or non-physician health care professional.
2302:
1979:"Canadian Ophthalmological Society Evidence-based Clinical Practice Guidelines for the Management of Diabetic Retinopathy - executive summary"
1846:"Teleophthalmology with optical coherence tomography imaging in community optometry. Evaluation of a quality improvement for macular patients"
617:). The medical imaging standard is managed by the Medical Imaging & Technology Alliance (MITA), which is a division of the Virginia-based
2170:
1125:
Boucher, Marie Carole; Gilles Desroches; Raul Garcia-Salinas; Amin Kherani; David Maberley; SĂ©bastien Olivier; Mila Oh; Frank Stockl (2008).
618:
1920:
Abrà moff, Michael D; Joseph M Reinhardt; Stephen R Russell; James C Folk; Vinit B Mahajan; Meindert Niemeijer; Gwénolé Quellec (June 2010).
223:, though it is also performed by specially trained staff. Image evaluation may also be automated to provide pathology detection or grading.
583:
Since 2001, more than 30,000 people with diabetes have been screened since 2001 as part of a project called EyeCheck in the Netherlands.
563:
announced the development of a diabetic retinopathy screening programme. The Diabetic RetinaScreen programme was rolled out in 2013.
624:
Various regulations exist on national levels that govern the use of teleophthalmological solutions. Some of them are listed below:
445:
1712:
1580:
831:
Helveston, Eugene M.; Faruk H. Orge; Rosa Naranjo; Lourdes Hernandez (October 2001). "Telemedicine: Strabismus e-consultation".
654:
Telehealth networks are growing in number, and advancements are being made in automated detection methods for diseases such as
239:
drives the underlying technology in automated image recognition. Specific approaches involve pattern recognition using trained
1450:
705:
75:
and adnexal eye diseases. Less common conditions that can be revealed using retinal images are arterial and vein occlusions,
575:
has screened 2500 people in Kenya, and incorporates geo-tagging to facilitate follow-up treatment and demographic research.
1687:
2455:
464:
1520:"Telehealth Benefits and Adoption: Connecting People and Providers Across Canada. Commissioned by Canada Health Infoway"
422:
2322:
1331:
Bursell, Sven-Erik; Laima Brazionis; Alicia Jenkins (May 2012). "Telemedicine and ocular health in diabetes mellitus".
560:
449:
299:
was performed in the remote areas of Western Australia. Projects are now being started base on this pilot experience.
2163:
716:
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Use of videoconferencing to members of the human resources department has helped to resolve emergency staffing issues
1519:
2330:
2272:
1035:"Nonmydriatic Fundus Photography for Teleophthalmology Diabetic Retinopathy Screening in Rural and Urban Clinics"
2131:
520:
Between 2006 and 2008, a large scale teleretinal screening project using mobile units was implemented in China.
1184:
Rudnisky, Christopher J.; Matthew T.S. Tennant; Alexander R. de Leon; Bradley J. Hinz; Mark D.J. Greve (2006).
380:
Teleophthalmology is provided by ophthalmologists from the University of British Columbia, and is supported by
495:
There are a number of teleophthalmology programs in Quebec, following on a feasibility study completed by the
409:
385:
211:. Image evaluation, to detect various pathologies in the case of asynchronous evaluation, is often done by an
675:
examinations using traditional binocular observation with standard 7-field stereoscopic fundus photography.
2156:
1615:
476:
181:
92:
774:
Richter, Grace M.; Steven L. Williams; Justin Starren; John T. Flynn; Michael F. Chiang (November 2009).
169:
130:
Fundus photography is performed by a fundus camera, which basically consists of a specialized low power
2307:
437:
240:
64:
876:"Application of tele-ophthalmology in remote diagnosis and management of adnexal and orbital diseases"
532:
supports diabetic retinal screening across 34 sites and has screened over 13,000 patients since 2004.
2379:
1801:"Annual Report English National Screening Programme for Diabetic Retinopathy April 2010 - March 2011"
636:
593:
1186:"Benefits of stereopsis when identifying clinically significant macular edema via teleophthalmology"
2335:
2239:
154:
in a "store-and-forward" method, where data is captured and transmitted for review at a later time.
141:
Teleophthalmology services can be provided primarily in two ways synchronously or asynchronously:
59:
Current teleophthalmological solutions are generally focused on a particular eye problem, such as
2198:
1435:
2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society
1127:"Teleophthalmology screening for diabetic retinopathy through mobile imaging units within Canada"
662:
405:
381:
348:
236:
100:
2029:
Bittner, Ava K.; Yoshinaga, Patrick D.; Wykstra, Stephanie L.; Li, Tianjing (27 February 2020).
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Thirteen teleophthalmology programs currently exist in Ontario. Two of the programs facilitate
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A number of teleophthalmology programs exist in Canada, including those in the provinces of
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1804:
655:
457:
275:
More effective planning and administrative meetings with point-and-click sharing of content
68:
60:
935:"The Use of Retinal Photography in Nonophthalmic Settings and Its Potential for Neurology"
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8:
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87:, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment.
1896:"Researchers say pioneering emergency eye care trial leads to quicker treatment times"
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Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) program
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teleophthalmology software to provide this service. Some of these locations use a
441:
397:
356:
312:
933:
Pérez, Mario A.; Beau B. Bruce; Nancy J. Newman; Valérie Biousse (November 2012).
776:"Telemedicine for Retinopathy of Prematurity Diagnosis: Evaluation and Challenges"
2470:
2399:
2103:
1937:
1550:
1481:
1395:
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369:
212:
104:
76:
1825:"Teleophthalmology with optical coherence tomography imaging in the community".
932:
2429:
2384:
2374:
2369:
2345:
2224:
2216:
1995:
1978:
1636:
Vinekar A, Gilbert C, Dogra M, Kurian M, Shainesh G, Shetty B, Bauer N (2014).
1442:
700:. K Yogesan, J Cuadros (eds.). Berlin, Heidelberg: Springer Berlin Heidelberg.
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Teleophthalmology has been provided in Alberta since 2003, and is supported by
248:
244:
208:
2148:
1081:
1003:
352:
251:
techniques; and content-based comparison with previously adjudicated samples.
2485:
2434:
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2004:
1945:
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Stanzel, B.V.; C.H. Meyer (2012-01-26). "Smartphones in der Augenheilkunde".
958:
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has reached more than 450,000 patients since its inception in October, 2003.
509:
472:
433:
190:
84:
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844:
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locations. The teleophthalmology program also facilitates approximately 55
24:
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2119:
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2012:
1963:
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36:
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Journal of American Association for Pediatric Ophthalmology and Strabismus
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to transmit images to an ophthalmologist for evaluation. OTN uses
316:
16:
596:, and is currently being piloted in other Scottish health boards.
2364:
2297:
730:
529:
324:
308:
115:
1843:
1518:
Gartner Inc.; Praxia Information Intelligence . (May 30, 2011).
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2340:
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873:
328:
135:
123:
614:
497:
institut national d'excellence en santé et en service sociaux
572:
540:
The teleophthalmology program provided in Chennai, India by
698:
Digital Teleretinal Screening Teleophthalmology in Practice
666:
compromise possible funding or support for these services.
496:
2028:
1635:
269:
Education of hospital staff, clinicians and the community
97:
1713:"Transcript of "Get your next eye exam on a smartphone""
468:
645:
91:
Recently, emerging retinal imaging modalities such as
351:, using their proprietary teleophthalmology software
669:
2245:
Health Insurance Portability and Accountability Act
1922:"Automated early detection of diabetic retinopathy"
1844:Kelly, SP; I Wallwork; D Haider; K Qureshi (2011).
1837:
1581:"Dépistage de la rétinopathie diabétique au Québec"
874:Verma, Malay; Rajiv Raman; RavindraE Mohan (2009).
630:
Health Insurance Portability and Accountability Act
266:
Extended patient care and expertise to remote areas
1688:"The slow birth of Diabetic Retinopathy Screening"
285:
20:Healthy eye fundus viewed through a retinal camera
1045:(2). Telemedicine Journal and E Health: 102–108.
989:
502:Dépistage de la rétinopathie diabétique au Québec
2483:
28:Retinal image with signs of macular degeneration
2178:
2031:"Telerehabilitation for people with low vision"
1179:
1177:
2303:Participative decision-making in organizations
1032:
396:In Manitoba, teleophthalmology is provided by
226:
2164:
1033:Chin EK, Ventura BV, See KY (February 2014).
726:
724:
619:National Electrical Manufacturers Association
436:support for premature infants, screening for
2088:"Screening options for diabetic retinopathy"
1913:
1731:
1285:
1174:
608:
107:for use by the general public are emerging.
2035:The Cochrane Database of Systematic Reviews
1118:
695:
573:PEEK (Portable Eye Examination Kit) program
2171:
2157:
1970:
1326:
1324:
1233:
983:
721:
689:
339:realized from separate funding envelopes.
2062:
1994:
1953:
1871:
1861:
1759:
1663:
1653:
1058:
966:
909:
891:
807:
295:A 100-case audit of retinal screening by
165:: standard digital stills or video camera
1799:UK National Screening Committee (2011).
926:
824:
114:
23:
15:
1888:
1792:
1321:
1075:
2484:
1529:
1511:
1437:. Vol. 2007. pp. 6743–6746.
767:
2152:
2024:
2022:
1426:
1375:
2085:
2079:
1243:Progress in Retinal and Eye Research
867:
1333:Clinical and Experimental Optometry
646:Future direction and considerations
375:
13:
2323:Health information on the Internet
2019:
1475:
477:optical coherence tomography (OCT)
450:McMaster University Medical Centre
14:
2508:
1983:Canadian Journal of Ophthalmology
1193:Canadian Journal of Ophthalmology
1134:Canadian Journal of Ophthalmology
1084:Telemedicine Journal and e-Health
792:10.1016/j.survophthal.2009.02.020
733:Canadian Journal of Ophthalmology
670:Current technological limitations
586:
50:
2092:Current Opinion in Ophthalmology
1345:10.1111/j.1444-0938.2012.00746.x
1255:10.1016/j.preteyeres.2005.07.001
599:
2456:Open-source healthcare software
2331:Health information on Knowledge
2134:from the original on 2024-07-13
2086:Chew, Emily Y (December 2006).
1902:from the original on 2024-07-13
1818:
1719:from the original on 5 May 2014
1705:
1694:from the original on 2014-10-31
1680:
1629:
1618:from the original on 2024-07-13
1604:
1593:from the original on 2024-07-13
1573:
880:Indian Journal of Ophthalmology
465:teleophthalmology (TOP) service
415:
286:Implemented projects by country
2047:10.1002/14651858.CD011019.pub3
1026:
605:screened through the program.
578:
263:Strengthened referral patterns
152:Asynchronous teleophthalmology
45:ophthalmologist or optometrist
1:
745:10.1016/S0008-4182(05)80091-2
682:
475:, others use both fundus and
254:
146:Synchronous teleophthalmology
2104:10.1097/ICU.0b013e328010948d
1938:10.1016/j.ophtha.2010.03.046
1551:10.1016/j.ophtha.2011.11.036
1396:10.1097/IAE.0b013e31818356dd
951:10.1097/NRL.0b013e318272f7d7
462:Ontario Telemedicine Network
458:Ten of these eleven programs
290:
243:; feature extraction using
199:(pupil dilation, e.g. using
93:optical coherence tomography
7:
2273:Doctor–patient relationship
2180:Telemedicine and telehealth
391:
227:Automated image recognition
10:
2513:
2308:Patient Activation Measure
1996:10.1016/j.jcjo.2012.01.022
1443:10.1109/IEMBS.2007.4353909
554:
438:retinopathy of prematurity
427:
342:
241:artificial neural networks
110:
65:retinopathy of prematurity
2448:
2380:Remote patient monitoring
2354:
2321:
2258:
2215:
2186:
1740:Telemedicine and e-Health
1295:Singapore Medical Journal
1039:Telemedicine and e-Health
1004:10.1007/s00347-011-2425-7
637:Data Protection Directive
609:Standards and regulations
594:University of Strathclyde
523:
490:
410:Secure Diagnostic Imaging
404:, and is supported using
386:Secure Diagnostic Imaging
353:Secure Diagnostic Imaging
302:
2336:Online patient education
2240:Electronic health record
1655:10.4103/0301-4738.126178
696:Goldschmidt, LP (2012).
566:
561:Health Service Executive
535:
515:
406:Alberta Health Service's
382:Alberta Health Service's
1752:10.1089/tmj.2005.11.668
893:10.4103/0301-4738.55078
845:10.1067/mpa.2001.118214
780:Survey of Ophthalmology
349:Alberta Health Services
237:artificial intelligence
2461:Patient opinion leader
2313:Shared decision-making
2250:Personal health record
1850:Clinical Ophthalmology
1827:Clinical Ophthalmology
1096:10.1089/tmj.2005.11.79
402:University of Manitoba
235:Dedicated research in
221:primary care physician
127:
29:
21:
2293:Knowledge translation
2260:Patient participation
1051:10.1089/tmj.2013.0042
372:referrals per month.
361:University of Alberta
355:. Approximately six
260:Improved patient care
177:connected to a camera
118:
27:
19:
2466:Research participant
1612:"KIDROP | Home"
1485:Connecticut Medicine
656:diabetic retinopathy
69:macular degeneration
61:diabetic retinopathy
2187:Background concepts
1863:10.2147/OPTH.S26753
1642:Indian J Ophthalmol
2440:Telerehabilitation
2194:Health informatics
1833:: 1673–1678. 2011.
542:Sankara Nethralaya
423:TopCon Canada Inc.
272:Cost-effectiveness
207:, enhancement and
128:
103:2022-03-14 at the
30:
22:
2479:
2478:
2415:Teleophthalmology
2405:Telemental health
2390:Tele-epidemiology
2235:De-identification
2207:Telecommunication
1715:. 30 April 2014.
1452:978-1-4244-0787-3
1390:(10): 1463–1477.
992:Der Ophthalmologe
707:978-3-642-25810-7
182:Posterior segment
134:with an attached
85:renal dysfunction
33:Teleophthalmology
2504:
2288:Health education
2173:
2166:
2159:
2150:
2149:
2143:
2142:
2140:
2139:
2083:
2077:
2076:
2066:
2026:
2017:
2016:
1998:
1974:
1968:
1967:
1957:
1932:(6): 1147–1154.
1917:
1911:
1910:
1908:
1907:
1892:
1886:
1885:
1875:
1865:
1841:
1835:
1834:
1822:
1816:
1815:
1813:
1812:
1803:. Archived from
1796:
1790:
1789:
1763:
1735:
1729:
1728:
1726:
1724:
1709:
1703:
1702:
1700:
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1623:
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1570:
1545:(6): 1167–1174.
1533:
1527:
1526:
1524:
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1509:
1508:
1479:
1473:
1472:
1430:
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1024:
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864:
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822:
821:
811:
771:
765:
764:
728:
719:
711:
693:
641:Japan - HPB 517
482:ophthalmologists
469:Merge Healthcare
442:ophthalmologists
398:ophthalmologists
376:British Columbia
357:ophthalmologists
313:British Columbia
170:Anterior segment
2512:
2511:
2507:
2506:
2505:
2503:
2502:
2501:
2482:
2481:
2480:
2475:
2471:Virtual patient
2444:
2400:Teledermatology
2350:
2317:
2254:
2211:
2182:
2177:
2147:
2146:
2137:
2135:
2084:
2080:
2041:(2): CD011019.
2027:
2020:
1975:
1971:
1918:
1914:
1905:
1903:
1894:
1893:
1889:
1842:
1838:
1824:
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1819:
1810:
1808:
1797:
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1522:
1516:
1512:
1480:
1476:
1453:
1431:
1427:
1380:
1376:
1329:
1322:
1301:(11): 715–719.
1290:
1286:
1238:
1234:
1225:
1223:
1205:10.3129/I06-066
1188:
1182:
1175:
1166:
1164:
1146:10.3129/I08-120
1129:
1123:
1119:
1080:
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1031:
1027:
988:
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939:The Neurologist
931:
927:
872:
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829:
825:
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768:
729:
722:
708:
694:
690:
685:
672:
663:Cochrane review
648:
611:
602:
589:
581:
569:
557:
538:
530:OPHDIAT Network
526:
518:
493:
430:
418:
394:
378:
370:ophthalmologist
345:
305:
293:
288:
257:
229:
213:ophthalmologist
113:
105:Wayback Machine
77:chorioretinitis
53:
35:is a branch of
12:
11:
5:
2510:
2500:
2499:
2494:
2477:
2476:
2474:
2473:
2468:
2463:
2458:
2452:
2450:
2446:
2445:
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2432:
2430:Telepsychiatry
2427:
2422:
2417:
2412:
2407:
2402:
2397:
2392:
2387:
2385:Tele-audiology
2382:
2377:
2375:Remote therapy
2372:
2370:Remote surgery
2367:
2361:
2359:
2357:subspecialties
2352:
2351:
2349:
2348:
2346:PubMed Central
2343:
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2327:
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2319:
2318:
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2247:
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2225:Admission note
2221:
2219:
2217:Medical record
2213:
2212:
2210:
2209:
2204:
2196:
2190:
2188:
2184:
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2161:
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2144:
2098:(6): 519–522.
2078:
2018:
1969:
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1887:
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1817:
1791:
1746:(6): 668–674.
1730:
1704:
1690:. 2013-06-28.
1679:
1628:
1603:
1572:
1528:
1510:
1474:
1451:
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1339:(3): 311–327.
1320:
1284:
1232:
1199:(6): 727–732.
1173:
1140:(6): 658–668.
1117:
1074:
1025:
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945:(6): 350–355.
925:
866:
839:(5): 291–296.
823:
786:(6): 671–685.
766:
739:(6): 734–742.
720:
706:
687:
686:
684:
681:
671:
668:
647:
644:
643:
642:
639:
633:
610:
607:
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587:United Kingdom
585:
580:
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508:2014-02-27 at
492:
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249:region-growing
245:edge-detection
228:
225:
209:edge-detection
194:
193:
178:
166:
156:
155:
149:
126:retinal camera
112:
109:
52:
51:Implementation
49:
9:
6:
4:
3:
2:
2509:
2498:
2495:
2493:
2492:Ophthalmology
2490:
2489:
2487:
2472:
2469:
2467:
2464:
2462:
2459:
2457:
2454:
2453:
2451:
2449:Roles to play
2447:
2441:
2438:
2436:
2435:Teleradiology
2433:
2431:
2428:
2426:
2423:
2421:
2420:Telepathology
2418:
2416:
2413:
2411:
2408:
2406:
2403:
2401:
2398:
2396:
2395:Teledentistry
2393:
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2381:
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2368:
2366:
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2360:
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2355:Telemedicine
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2268:Decision aids
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2169:
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2060:
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2023:
2014:
2010:
2006:
2002:
1997:
1992:
1988:
1984:
1980:
1973:
1965:
1961:
1956:
1951:
1947:
1943:
1939:
1935:
1931:
1927:
1926:Ophthalmology
1923:
1916:
1901:
1897:
1891:
1883:
1879:
1874:
1869:
1864:
1859:
1856:(5): 1673–8.
1855:
1851:
1847:
1840:
1832:
1828:
1821:
1807:on 2012-11-10
1806:
1802:
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1539:Ophthalmology
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717:3-642-25809-3
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634:
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626:
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620:
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600:United States
597:
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576:
574:
564:
562:
559:In 2011, the
552:
550:
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543:
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531:
521:
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511:
510:archive.today
507:
504:
503:
498:
488:
485:
483:
478:
474:
473:fundus camera
470:
466:
463:
459:
453:
451:
447:
443:
440:(RoP), using
439:
435:
434:ophthalmology
425:
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399:
389:
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191:fundus camera
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2497:Telemedicine
2425:Telepharmacy
2414:
2199:
2136:. Retrieved
2095:
2091:
2081:
2038:
2034:
1989:(2): 91–96.
1986:
1982:
1972:
1929:
1925:
1915:
1904:. Retrieved
1890:
1853:
1849:
1839:
1830:
1826:
1820:
1809:. Retrieved
1805:the original
1794:
1743:
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1733:
1721:. Retrieved
1707:
1696:. Retrieved
1682:
1645:
1641:
1631:
1620:. Retrieved
1606:
1595:. Retrieved
1575:
1542:
1538:
1531:
1513:
1491:(2): 85–90.
1488:
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1224:. Retrieved
1196:
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1137:
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1090:(1): 79–83.
1087:
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886:(5): 381–4.
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501:
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486:
454:
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419:
416:Newfoundland
408:proprietary
395:
384:proprietary
379:
346:
337:
333:
321:Newfoundland
306:
297:optometrists
294:
234:
230:
195:
186:
180:
168:
163:External eye
162:
157:
151:
145:
140:
129:
89:
81:hypertension
58:
54:
42:
37:telemedicine
32:
31:
2410:Telenursing
2230:Blue Button
2202:health care
2200:In absentia
1761:1874/204248
1648:(1): 41–9.
998:(1): 8–20.
579:Netherlands
499:, entitled
366:optometrist
217:optometrist
205:compression
201:tropicamide
2486:Categories
2283:Health 2.0
2138:2020-04-02
1906:2019-11-10
1811:2012-12-15
1698:2014-10-31
1622:2014-04-30
1597:2024-07-13
1226:2012-12-15
1167:2012-12-15
683:References
635:Europe -
412:software.
388:software.
255:Advantages
132:microscope
73:strabismus
2278:E-patient
2112:1040-8738
2055:1469-493X
2005:0008-4182
1946:1549-4713
1770:1530-5627
1559:0161-6420
1497:0010-6178
1404:0275-004X
1353:0816-4622
1307:0037-5675
1263:1350-9462
1213:1715-3360
1154:1715-3360
1104:1530-5627
1012:0941-293X
959:1074-7931
902:0301-4738
853:1091-8531
800:0039-6257
753:0008-4182
661:A recent
446:Sick Kids
359:from the
291:Australia
197:Mydriasis
175:slit lamp
121:mydriatic
2132:Archived
2128:23958724
2120:17065919
2073:32102114
2013:22560411
1964:20399502
1900:Archived
1898:. 2019.
1882:22174576
1786:23886703
1778:16430386
1717:Archived
1692:Archived
1674:24492500
1616:Archived
1588:Archived
1567:22406031
1505:22670358
1469:24491954
1461:18003575
1412:18997609
1369:24437145
1361:22594547
1315:23192497
1271:16154379
1221:17224954
1162:19020631
1112:15785224
1069:24219153
1020:22274293
977:23114666
920:19700877
861:11641638
818:19665742
761:16391638
621:(NEMA).
506:Archived
460:use the
392:Manitoba
317:Manitoba
101:Archived
98:Eye-File
2365:eHealth
2298:mHealth
2064:7043933
1955:2881172
1873:3236713
1665:3955069
1420:9612772
1279:7434103
1060:3910561
968:3521530
911:2804127
809:2760626
628:USA -
555:Ireland
428:Ontario
400:at the
343:Alberta
325:Ontario
309:Alberta
111:Process
2341:PubMed
2126:
2118:
2110:
2071:
2061:
2053:
2011:
2003:
1962:
1952:
1944:
1880:
1870:
1784:
1776:
1768:
1672:
1662:
1565:
1557:
1503:
1495:
1467:
1459:
1449:
1418:
1410:
1402:
1384:Retina
1367:
1359:
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1313:
1305:
1277:
1269:
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1160:
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965:
957:
918:
908:
900:
859:
851:
816:
806:
798:
759:
751:
715:
704:
524:France
491:Quebec
329:Quebec
327:, and
303:Canada
187:retina
136:camera
124:Topcon
119:A non-
2124:S2CID
1782:S2CID
1723:5 May
1591:(PDF)
1584:(PDF)
1523:(PDF)
1465:S2CID
1416:S2CID
1365:S2CID
1275:S2CID
1189:(PDF)
1130:(PDF)
615:DICOM
567:Kenya
536:India
516:China
2116:PMID
2108:ISSN
2069:PMID
2051:ISSN
2039:2020
2009:PMID
2001:ISSN
1960:PMID
1942:ISSN
1878:PMID
1854:2011
1774:PMID
1766:ISSN
1725:2014
1670:PMID
1563:PMID
1555:ISSN
1501:PMID
1493:ISSN
1457:PMID
1447:ISBN
1408:PMID
1400:ISSN
1357:PMID
1349:ISSN
1311:PMID
1303:ISSN
1267:PMID
1259:ISSN
1217:PMID
1209:ISSN
1158:PMID
1150:ISSN
1108:PMID
1100:ISSN
1065:PMID
1016:PMID
1008:ISSN
973:PMID
955:ISSN
916:PMID
898:ISSN
857:PMID
849:ISSN
814:PMID
796:ISSN
757:PMID
749:ISSN
713:ISBN
702:ISBN
571:The
547:The
528:The
448:and
368:-to-
247:and
2100:doi
2059:PMC
2043:doi
1991:doi
1950:PMC
1934:doi
1930:117
1868:PMC
1858:doi
1756:hdl
1748:doi
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