Nursing technicians can help expand reach of ophthalmology

Under remote supervision of an ophthalmologist, trained technicians can also take ophthalmic photographs that are adequate for remote reading, a recent study has found.

Researchers conducted a cross-sectional analysis of 2,044 images obtained from 118 patients. Both on-site ophthalmologists and a trained nursing team used fundus and slit-lamp photography to obtain the photos; the nursing team was under the remote supervision of an ophthalmologist. The quality of the images was assessed by another ophthalmologist masked to the photographer, and the proportion of suitable images was compared between the groups.

Of the 1,022 photos taken by the on-site ophthalmologists, 965 (94.4 percent) were deemed suitable; the nurse technician team, on the other hand, took 958 suitable photos (93.7 percent). The difference was not statistically significant (p=0.512).

Even when disaggregating by image type, the adequacy of photos taken was generally comparable between the nursing team and the ophthalmologists. For instance, there was a similar number of suitable photos of the anterior segment with diffuse illumination (p=0.825) and of the slit on anterior chamber periphery (p=0.997) between groups.

The same was true for macular-centred (p=0.194) and optic disc-centred (p=0.449) fundus photographs.

The only exception was for photographs with the slit centred on the pupil, for which on-site ophthalmologists performed significantly better (99.6 percent vs 93.8 percent; p=0.001).

“These findings provide favourable evidence of teleophthalmology programmes that are locally operated by technicians in expanding ophthalmic expertise through remote evaluation of images,” the researchers said.