Tele-Ophthalmology for the Management and AssessmenT of Ophthalmic Symptoms (TOMATO): An Assessment of the Telemedicine Services at a Tertiary Eye Center in the Philippines

Background: The COVID-19 pandemic has led to the rapid adoption of telemedicine in the Philippines; however, there is limited empirical evidence about how physicians and patients view this new form of care. Objective: Our main objective is to evaluate Tele-Ophthalmology for the Management and AssessmenT of Ophthalmic Symptoms (TOMATO), a tele-ophthalmology program implemented in a national tertiary eye referral center in the Philippines. We specifically aim to evaluate the patient characteristics, patient satisfaction, and ophthalmologists' perception of TOMATO telemedicine for eye care. Methodology: We employed a prospective, cross-sectional, questionnaire-based study among patients and physicians who participated in TOMATO during the study period. Results: A total of 10,551 patients consulted TOMATO, from January to December 2021, with cataract as the most common diagnosis. During its pilot implementation, TOMATO received a low satisfaction rate of 33% among patients due to numerous barriers to its use, including technical and interpersonal problems. Filipino ophthalmologists had good knowledge and a positive attitude towards the use of TOMATO, with a mean score of 3.53 out of 5. Conclusions: Tele-ophthalmology is a promising technology for improving access to eye care in the Philippines, but there are still some challenges that need to be addressed, such as improving the user experience, ensuring data security, and training future ophthalmologists in its use.