Eye care

TeleEye Screening focuses on preventative care – Part Two – VAntage Point – VAntage Point Blog

VA TeleEye has evolved over time, with each program building on the success of previous iterations. Initially, the only service offered was the TeleRetinal screening for diabetic retinopathy.

Launching in 2006, this service enabled an eye specialist to screen patients for diabetic retinopathy through photographs taken at the primary medical care home. It built the foundation for VA to deliver eye care through telehealth across the country.

Now VA TeleEye is provided under three major programs: the TeleEye Screening Program, the Technology-based Eye Care Services (TECS) Program, and the Tele-Low Vision Eye Care Program.

The TeleEye Screening Program focuses on preventative care. It identifies Veterans that are at high risk for different types of eye disease, such as diabetic retinopathy, macular degeneration and glaucoma, and it brings them in for eye screenings.

TECS provides a range of remote eye care services, including screening for diabetic retinopathy, glaucoma, macular degeneration and cataracts. TECS also provides vision checking and eyeglass prescriptions as needed. Many Veterans are introduced to TECS because they need eyeglasses but then can use the service to receive other follow-up eye care as needed.

Ophthalmologist Dr. April Maa is the national lead for this program.

Saves Veterans and caregivers hours of commuting

The Tele-Low Vision TeleEye Care Program offers vision rehabilitative services to Veterans with vision loss through real-time video technologies. These services help Veterans improve their quality of life by increasing their ability to function with the vision that they have. Delivering this program through telehealth is highly effective because many of these Veterans do not meet the legal vision requirements to drive.

The program saves the Veteran and their caregiver hours of commuting and coordination time for getting to an in-person visit.

These three programs work together to help Veterans across the country receive the eye care they need, ranging from preventative care to vision loss services. Right now, VA offers TeleEye at nearly 800 unique VA facilities across the country. Eye care is the third most-used health care service at VA, exceeded only by primary care and mental health care.

Vision care is a critically important service because visual impairment is directly linked to quality of life. Vision loss can affect a Veteran’s ability to drive, watch TV, read and use the internet. Not only can this increase a Veteran’s feelings of isolation, but it can also make them feel dependent on their family members and caregivers.

People who experience vision loss are also more likely to experience depression and to enter a nursing home, leading to higher rates of morbidity and mortality. This is why Veterans must have access to eye care facilities where they can regularly screen for and treat eye diseases.

“As people get older, they are at greater risk for potentially blinding eye diseases that they won’t even know they have,” said Maa. “If you are regularly screened, you’re going to be able to protect your vision and keep your eyes healthy long term.”

Eyes on the future

The TeleEye program is continuing to explore ways for telehealth to help supplement care and maintain access to in-person clinics. One such example is “remote refraction,” where eye providers can remotely control equipment to measure a Veteran’s prescription for eyeglasses and contacts.

The provider performs the procedure during a real-time video visit with the Veteran, fine-tuning measurements across the internet based on the Veteran’s feedback. Performing this test remotely enables skilled eye care providers to serve more Veterans throughout the country, instead of being tied to only one clinic.

Another pilot program in development, called Tele-Eye Express, aims to increase the accessibility of eye care by using more portable equipment. Technicians can bring the equipment to patients who have mobility issues or who cannot travel, such as those in a spinal cord injury unit or a nursing home.

Program aims to constantly improve patient experience

The portable equipment also provides a rapid response element to eye care, which can be critical for Veterans in the emergency room for acute vision loss or other serious eye conditions. This ability to offer a prompt ocular consultation upon request, wherever the patient may be, will be an additional enhancement to patient care.

Ultimately, the VA TeleEye program aims to constantly improve the patient experience while expanding its accessibility to include as many Veterans as possible. “Whether a Veteran is seen in person or through telehealth, they can have confidence that they’re receiving high-quality care and we can meet their needs,” said Optometrist Dr. Timothy Elcyzyn.

To learn more about VA TeleEye, visit the VA Telehealth website.

Read Part One of this series.

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