The Toronto Tele-Retinal Screening Program for the Elderly in Long-Term Care: A Pilot Project

Michelle Lim,1 Tina Felfeli,2,3 Winnie Mangubat,4 Hamid Moghimi,4 Michael Grinton,5 Michael H Brent1,2,6 1Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 2Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 3Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; 4South Riverdale Community Health Centre, Toronto, ON, Canada; 5Department of Ophthalmology, Sunderland Eye Infirmary, Sunderland, UK; 6Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, ON, CanadaCorrespondence: Michael H Brent, Email [email protected]: To report the results and feasibility of a pilot expansion of the Toronto Tele-Retinal Screening Program in an elderly long-term care home.Methods: Long term care patients with Type II diabetes mellitus (DM) were screened between April 1, 2022, and July 1, 2022. Demographic and health data were collected through surveys.Results: A total of 28 patients were screened, with 85.7% successfully undergoing retinal imaging. Among imaged patients, 8.3% (2/24) required urgent follow-up. Pathologies identified included uncontrolled glaucoma (4.1%, 1/24), non-proliferative diabetic retinopathy (8.3%, 2/24), and age-related macular degeneration (45.8%, 11/24). The handheld camera successfully screened 60% (3/5) of patients with mobility issues. Overall, 90% (17/19) of patients rated their experience as either “brilliant” or “really good”.Discussion: This pilot project demonstrated the necessity for routine eye care in the elderly and the potential for widespread implementation of teleophthalmology in long-term care facilities. With only 14.3% (4/28) of patients unable to be imaged, this program offers a feasible, patient-friendly alternative to in-clinic screening. Future policies and practices in teleophthalmology should consider the unique needs of long-term care residents and the potential for reducing healthcare disparities through such a program.Keywords: teleophthalmology, diabetes, retinopathy, elderly care, telemedicine, healthcare accessibility