Eyeworld

98 | EYEWORLD | SPRING 2025 G UCOMA disease." The other area where innovation is oc- curring is in different protocols where the tech- nician and doctor are connecting live. "We're looking at using this live video connection in the evaluation of complex things like double vision," she said. During the pandemic, Dr. Maa said they had to do a lot only by Zoom because they weren't letting anyone except for emergency cases come in. Once the pandemic subsided some and vac- cines became available, telehealth care ramped up substantially as part of the effort to reach out to patients and "catch up" on appointments that had previously been canceled. In addition, telehealth has increased clinic organization. "Another thing we have done is we have used telehealth to be our ophthalmology presence to support an optometry-only clinic, and we'll trav- el to that optometry clinic to see patients who we initially triaged through telehealth." They see 100 patients via telehealth and know which patients need laser, gonioscopy, etc. "Patients will come on a day when the doctor is physical- ly there, then we do the procedures and lasers that are needed. We've made that doctor's time efficient and high yield in terms of procedures. That's also been helpful to make the clinic more efficient." Grayson W. Armstrong, MD, MPH Dr. Armstrong also had some experience with telemedicine prior to the pandemic. "I think when the pandemic hit, everyone started scram- bling and figuring out what they needed to do or what they might have at their fingertips," he said. "At that point, the only thing that we had done before was diabetic retinopathy screening using fundus photos." Dr. Armstrong was in a telemedicine fellow- ship at Mass Eye and Ear during the pandemic. "I had talked to the hospital leadership and negotiated this fellowship and helped create the curriculum for it before the pandemic started. When the pandemic happened, everyone looked to me and said, 'What can we do?'" He said they tried implementing hybrid telemedicine, which had varying degrees of suc- cess. "The way we define hybrid telemedicine is a patient will come to a testing center or into the office and get testing done in a testing-on- ly visit," he said. "The doctor will review the testing and hop on a video call or telephone call and talk about the results. In that way, you can get any testing you'd get in the office and have all that data at your fingertips." Dr. Armstrong said this was helpful for patients with glaucoma or suspected glaucoma, continued from page 96 The VECS technician checks the patient's eye pressure with rebound tonometry. Source: Amy Fox A Virtual Eye Care Services (VECS) technician takes an auto-refraction measurement of a patient at the beginning of the exam. Source: Amy Fox

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