Use of telemedicine within adult strabismus management
Reviewed by Fiona Rowe

The aim of this survey was to assess the practice preferences in the management of adult strabismus among the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) committee members. A 27-question multiple-choice questionnaire was sent to 19 ophthalmologists on AAPOS committees, with 16 responses (84.2%). Forty percent had 5–10 years’ experience, 33.3% had >10 years and 26.6% had <5 years’ experience. One was excluded because of having no telemedicine experience. Eighty-six-point-seven percent were academic or affiliated with universities. Only two (13.3%) spent >50% of time in private practice. Telemedicine experience was 0–2 years. Eighty-six-point-seven percent agreed it was possible to perform ocular motility exams via webcam and most used laptops for this. Ninety-three-point-three percent would use a mobile app to capture nine positions, and >50% suggested orthoptists as the best professional figure to support data capture. They reported the most challenging conditions to capture included hypotropia, hypertropia, and exotropia. Mild strabismus and slight changes were hard to diagnose. Cranial nerve palsies, thyroid eye disease, sagging eye syndrome and myogenic strabismus were easier to diagnose. Sixty-six-point-seven percent would determine eligibility for surgery during a telemedicine visit and also consider postoperative evaluation with this. Eighty percent would not prescribe prisms or do preop assessments by telemedicine. They suggest its usefulness for initial screens and follow-up and for reducing waiting times for specialist visits. However, this requires careful use as a supplement to usual clinical practice.

AAPOS adult strabismus committee’s report on the status of adult strabismus telemedicine.
Vagge A, Roda M, Valsecchi N, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;60:386–9.