Telemedicine for screening eye disease in the remote Peruvian Amazon: proof-of-concept

Improvements in technology could facilitate task-shifting and ocular disease screening in rural areas. Visual acuity (VA) was tested using a Ministry of Health 3-m VA card. Anterior segment photographs were taken using a three-dimensional printed cellphone attachment and remotely graded. Of 326 photographed eyes, 1 was ungradable. Of 123 eyes with non-refractive visual impairment, cataract was identified in 35.8%, pterygium in 41.5%, corneal opacity in 5.7% and phthisis in 2.4%. While the cause of visual impairment cannot be determined without a posterior segment examination, the smartphone attachment proved to be easy to use by non-specialist workers and identified anterior segment pathology in most cases.