Cross-sectional study evaluates diagnostic agreement and referral compliance in teleophthalmology in rural India, suggesting systemic barriers impact patient outcomes.
Background: In rural India, the ophthalmologist-to-population ratio is severely imbalanced. Tele-ophthalmology via vision centers (VCs) staffed by mid-level ophthalmic personnel (MLOP) is a vital strategy for universal health coverage. Purpose: The purpose of the study was to evaluate the diagnostic agreement between MLOPs and ophthalmologists and to determine referral compliance rates in Western Odisha. Materials and Methods: A cross-sectional study of 583 nonroutine cataract cases across 10 VCs. Tele-consultation was conducted via the Integrated Community Outreach Module (ICOM), Google Meet, and WhatsApp video call. Results: The overall diagnostic agreement rate was 86.2%. Agreement was highest for endophthalmitis (100%), diabetic retinopathy, and chronic dacryocystitis. A ”safety-first” overdiagnosis trend was noted in trauma and corneal ulcers. However, 58% of referred patients failed to reach the base hospital. Conclusion: Tele-screening is highly accurate, but system-level barriers to referral compliance remain the primary challenge to sight preservation.
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Sahoo et al. (2025) studied this question.
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