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EP-122 - Teleophthalmology: Remote Refraction as Blindness Prevention Strategy in Primary Care in Brazil

Tuesday, May 1
11:55 AM - 12:10 PM
Location: Education Zone, Booth 2416, Screen 2

Uncorrected refraction errors account for more than 150 million patients presenting reversible severe vision loss all over the world. Brazil, due to its continental dimension, faces some challenges in addressing this blindness cause. Although there are enough certified ophthalmologists to cover the Brazilian population (1:15.800) they are not evenly distributed throughout the country and large areas are unserved.
Since 2007 the Brazilian Ministry of Health promotes the Telessaude Brasil Redes Program, that empowers multiple Telemedicine Nucleus in all States to offer teleducation and teleassistance to remote and unserved urban areas. We have been coordinating NUTTs - Nucleo de Telemedicina e Telessaude - in the State of Goias, Brazil, since 2007.
Teleophthalmology has been used by our center as a strategy in blindness prevention for the last 10 years through the use of itinerant non-mydriatic fundus cameras, where digital retinal pictures are remotely evaluated by ophthalmologists. It has been able to detect the four major blindness causes: cataract, glaucoma, diabetic retinopathy and age related macular disease. Still, the burden of uncorrected refraction errors had not been met.
We present the use of a portable wearable remote refraction system, using adaptive lens technology, to address this burden. All exams took place at Primary Care Units in the State of Goias, remotely supervised by a certified ophthalmologist. A portable refractometer linked to a wearable refractor was used to perform refraction exams in 1348 patients. Portable video slit lamp and video indirect ophthalmoscope were available and used whenever needed to address any special request from the remote ophthalmologist.
We present the design of this blindness prevention strategy, its results and a critical analysis of the lessons learned.
This remote refraction blindness prevention strategy is ready to be spread through Brazil as a permanent Teleophthalmology service and can be reproduced as an effective tool to prevent blindness from refractive errors, specially in underdeveloped countries.

Learning Objectives:

Alexandre C. Taleb

Universidade Federal de Goias

Alexandre C. Taleb, MD, PhD.
Telemedicine professor at Universidade Federal de Goiás Medical School (UFG).
PhD in Teleophthalmology / Telemedicine at USP (University of Sao Paulo)
NUTTs' Coordinator (Nucleo de Telemedicina e Telessaude FMUFG).
Former Ophthalmology Consultant of Brazilian Health Department
Ophthalmology Residency Coordinator at Hospital de Olhos Aparecida


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EP-122 - Teleophthalmology: Remote Refraction as Blindness Prevention Strategy in Primary Care in Brazil

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