Adaptation and implementation of ophthalmic telediagnosis services: a strategy for prevention of avoidable blindness in rural remote regions
1
Politics, Management and Health, School of Public Health, University of São Paulo (USP), São Paulo, Brazil
2
Community Health, Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo, Mozambique
3
NUTEL, Federal University of Minas Gerais (UFMG), Minas Gerais, Brazil
4
Institute of Public Health, Federal University of West Pará (UFOPA), Santarem, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A981
ABSTRACT
BACKGROUND:
Blindness due to Hypertension and, especially, Diabetes, although preventable, remains the main cause of visual loss in the productive population 1-3. In Brazil’s southwestern Amazon region of Pará state, thousands of people live without access to basic eye health care 4,5. We aimed to bring eye health care closer to the communities through the implementation of a regional university telehealth center, local staff training, health network integration, and strengthening strategies in preventing blindness and visual impairment.
METHODS:
Implementation pilot study in a Primary Health Unit set in a rural and remote municipality. Implementation phases: a) Situation analysis and coordination of activities with regional health authorities; b) Community health workers trained on counseling and active search procedures for high-risk patients, nurses/nursing technicians trained on visual acuity measurement and management of portable fundus cameras, the Phelcom Eyer2; c) The operationalization of eye screening. Visual acuity was measured, and images of anterior/posterior ocular follow-up were captured. Remote evaluation was done by an optometrist and ophthalmologist.
RESULTS:
The pilot included 15 Community Health Agents, 2 health professionals, and 1 manager, and 60 users with Diabetes and/or Hypertension. We found a lack of eye health care professionals in the public network, a deficit of materials and diagnostic equipment, and a lack of qualified referrals to the regional reference. The process of measurements and capture of ocular images was well accepted and adhered to by the participants, with high-quality images.
CONCLUSIONS:
It is possible to prevent avoidable blindness even in more challenging contexts, building each stage together with both health professionals and local health authorities, respecting and strengthening communities. The strategy has proven to be a facilitator of reliable remote diagnostics as well as an expander for access to eye care in regions with difficult access to eye health professionals, reducing this public health problem.
Blindness due to Hypertension and, especially, Diabetes, although preventable, remains the main cause of visual loss in the productive population 1-3. In Brazil’s southwestern Amazon region of Pará state, thousands of people live without access to basic eye health care 4,5. We aimed to bring eye health care closer to the communities through the implementation of a regional university telehealth center, local staff training, health network integration, and strengthening strategies in preventing blindness and visual impairment.
METHODS:
Implementation pilot study in a Primary Health Unit set in a rural and remote municipality. Implementation phases: a) Situation analysis and coordination of activities with regional health authorities; b) Community health workers trained on counseling and active search procedures for high-risk patients, nurses/nursing technicians trained on visual acuity measurement and management of portable fundus cameras, the Phelcom Eyer2; c) The operationalization of eye screening. Visual acuity was measured, and images of anterior/posterior ocular follow-up were captured. Remote evaluation was done by an optometrist and ophthalmologist.
RESULTS:
The pilot included 15 Community Health Agents, 2 health professionals, and 1 manager, and 60 users with Diabetes and/or Hypertension. We found a lack of eye health care professionals in the public network, a deficit of materials and diagnostic equipment, and a lack of qualified referrals to the regional reference. The process of measurements and capture of ocular images was well accepted and adhered to by the participants, with high-quality images.
CONCLUSIONS:
It is possible to prevent avoidable blindness even in more challenging contexts, building each stage together with both health professionals and local health authorities, respecting and strengthening communities. The strategy has proven to be a facilitator of reliable remote diagnostics as well as an expander for access to eye care in regions with difficult access to eye health professionals, reducing this public health problem.
| eISSN: | 2654-1459 |
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