Teleophthalmology-Enabled Direct Vitreoretinal Surgery Listing from Community Optometric Practice: Enhanced Efficiency During Coronavirus Disease 2019, and Beyond?

Purpose: To share a method of appropriately connecting patients directly to tertiary ophthalmology centers where subspecialist vitreoretinal (VR) surgical management is required during coronavirus disease 2019 (COVID-19). Methodology: We present our experience of a live teleophthalmology link directly connecting an optometrist to tertiary center VR team at the point of retinal detachment presentation within the community. Results: After the COVID-19 lockdown in National Health Service Forth Valley, Emergency Eye Care Treatment Centers have been set up where optometrists are the first point of contact for patients in the community. Live teleophthalmology link has enabled the optometrist in the community to connect directly with local ophthalmologists. From March 23 to June 15, 2020, five referrals were taken for a suspected retinal detachment, and one for submacular hemorrhage. From the receiving ophthalmologists' viewpoint, satisfaction for the quality of sound, video, and connection was 5/5 in all cases on a 5-point Likert grading; from the referring optometrists' viewpoint mean 4.6/5 for sound and video satisfaction, and 5/5 rating in all cases for connection reliability. On 5/6 occasions (83%) the receiving ophthalmologist connected directly with a VR surgeon in a tertiary center. Four-way communication between the patient, optometrist, receiving ophthalmologist, and VR surgeon enabled all five patients to be listed directly for VR surgery from the community, avoiding local ophthalmology department contact during the COVID-19 pandemic. Conclusion: Overall satisfaction and recommendation to others was rated 5/5 in all instances on a 5-point Likert grading, from the patient, optometrist, and ophthalmologist viewpoint.