The authors present a linked survey sent to patients and neuro-ophthalmologists after a consultation with one of 12 neuro-ophthalmologists from three centres in the United States, over a three-month period in 2020. All consultations were offered virtually due to restrictions on face-to-face consultations being limited to emergencies. Only video visits were included in this study. The total completed surveys included 159 completed by patients and 157 completed by neuro-ophthalmologists. The patient component of the survey was administered by the neuro-ophthalmologist verbally at the end of the consultation. The patient component consisted of five questions covering pre-consultation preparation, satisfaction with the virtual consultation, extra support requirements to better prepare, challenging aspects of the consultation, and comfort during the consultation. The neuro-ophthalmologist component consisted of four questions covering whether a full consultation was possible, which aspects were easy to gather information from, any aspects that could enhance the virtual consultation, and how many virtual consultations performed using the app. Two thirds of patients reported being satisfied with their consultation, three quarters found the pre-consultation instructions easy to understand but suggestions for improvements were made and most felt comfortable asking questions. Almost 90% of neuro-ophthalmologists felt confident to make decisions based on the information available. More than half found eye movements, visual acuity, Amsler grids and colour vision assessment easy. Challenges during consultations included being unable to perform fundoscopy, and pupil examination as well as issues with phone position and internet connection. The authors conclude that virtual examinations were well received by both patients and neuro-ophthalmologists and highlight areas of virtual examinations which could be strengthened including visual fields and optokinetic nystagmus (OKN) assessment. This study highlights what telemedicine is currently doing well for neuro-ophthalmology and what needs improvement. The authors do highlight several limitations of this study including the potential bias caused by the clinician verbally administering the survey. Further research is required to establish the best use for virtual neuro-ophthalmology consultations in the future.
