Objective:

To assess the feasibility of teleophthalmology for triage and management of corneal diseases at vision centres (VCs) in rural and semi-urban North India.

Approach:

• Study Design: A prospective observational study conducted from March to September 2024, including patients with corneal pathology presenting at VCs.
• Teleconsultation Process: Patients underwent preliminary examination at VCs, and images were sent to a cornea fellow at a tertiary centre for specialist consultation.
• Management Protocol: Vision technicians managed cases at VCs under specialist supervision, with acute cases receiving emergency care and referrals to secondary hospitals.

Key Findings:

• Of 4,825 patients with corneal disease, 2,022 (41.91%) were managed at VCs, while 2,803 (58.09%) were referred.
• Acute corneal cases comprised 1,852; non-acute cases comprised 2,973.
• Overall referral compliance was 27.58% (772 out of 2,803 referred cases).
• Significant predictors of referral uptake included proximity to hospitals and longer-established centres.

Interpretation:

Teleconsultation by specialist ophthalmologists enabled effective local triage and management of corneal diseases, reducing unnecessary referrals.

Limitations:

• The study only included patients who underwent teleconsultation, potentially limiting the generalizability of the findings.
• Referral compliance may be influenced by external factors not accounted for in the study.

Conclusion:

The teleophthalmology model can strengthen primary care in resource-constrained areas and may be applicable to other ocular specialties.