What to Know About Telehealth for Eye Health

Glaucoma, Cataracts, and Pink Eye Care

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In the age of COVID-19, telehealth for eye health has broader appeal than ever before. Besides the convenience of being able to undergo an eye exam in the comfort of your own home, this virtual approach has the added benefit of keeping both you and the eye care professional clear of any possible disease exposure.

Not surprisingly, many offices are now offering a swath of remote ophthalmic services for nonemergency cases.

Older couple views a health professional over a laptop on their kitchen table.

Marko Geber / DigitalVision / Getty Images

Even though medical and vision care offices are now taking more precautions than ever to see patients in person when necessary, you may still feel more comfortable using telehealth. This has become a viable option in many instances.

This is what you can typically expect if you have common eye conditions such as glaucoma, cataract, or pink eye.

When to Use Telehealth for Eye Health

Whether you have a chronic eye condition such as glaucoma, are slowly developing cataracts, or have a rapidly emergent case of pink eye, you may wish to avail yourself of telehealth options. Some situations when you might want to consider this include:

  • You wake up with a red eye with goopy discharge, and you want to know how to handle this. Do you need medication, or will home measures and time be enough?
  • You have longstanding glaucoma with access to a remote pressure-monitoring system, and you want to discuss medication adjustments and next steps.
  • You have been having more and more trouble reading lately and notice you're having difficulty seeing at night and worry you may have a cataract. You wonder what your options are.

You May Need to Be Seen in Person If...

Unfortunately, it's not always possible to conduct all needed tests or to perform necessary procedures remotely. Here are a few reasons you may have to be seen in person for these conditions:

  • The practitioner wants to see inside your eye and must dilate the pupil.
  • The doctor needs to use an office slit lamp to closely examine your cataract.
  • You need to get an accurate pressure measurement for your glaucoma and have no remote equipment.

Benefits and Challenges

Utilizing telehealth has some definite appeal. If you have glaucoma, cataract, or pink eye, here are some potential advantages to consider:

  • You don't have any issues with weather or traffic to consider and can remain comfortably in your own living room.
  • If you're contending with a condition that affects your vision even temporarily (like pink eye), driving or even navigating public transportation can be an issue. With telehealth, it's not a concern
  • You're not spending unnecessary time in a doctor's office, where you may be exposed to the germs of others.
  • Your practitioner gets the benefit of examining you while you're in the relaxed environment of your home. For example, this may give a glaucoma specialist a more accurate picture of your intraocular pressure under typical circumstances.
  • It may be possible to include other family members in the remote visit to offer insights on how you are managing a chronic condition such as cataracts or glaucoma.
  • A good smartphone or computer camera can easily help a practitioner visually assess something like pink eye, which involves the eye’s surface, and help them to decide whether an in-person visit is needed.

Challenges

While telehealth can be extremely helpful, there can also be some limitations to keep in mind:

  • Some aspects of an eye examination can’t be done remotely. While a computer or smartphone camera can clearly show the front of the eye, it cannot allow the practitioner to view the back of the eye.
  • By being in close proximity to the patient and actually touching the eye, the practitioner may pick up clues about the condition that they might not be able to otherwise.
  • It may be a little intimidating for some to figure out just how to navigate the technology needed to hold a telehealth visit.
  • Not all practices may offer telehealth services.
  • Not all private insurance companies will pay for this kind of visit, even in this more relaxed era. It’s important to check on this before setting up a telehealth visit.
  • While efforts are made to secure data, some people may have some security concerns about the visits.

How to Prepare for a Telehealth Visit for Eye Health

Preparing for a telehealth visit in some ways will seem very familiar but in others may require a few extra steps. Here’s what to keep in mind:

  • You need to determine if this is a service that your current practitioner is offering, and if not, who they suggest you contact that does have telehealth available.
  • Double-check that you have insurance coverage for telehealth visits.
  • Determine what kind of apps you will need for the visit and if your Internet connection is sufficient.
  • Ask if you need anything special on hand. Might you need a flashlight to allow for better examination of the eye?
  • Set up a quiet, well-lit space in your home for the telehealth visit.
  • Write down any symptoms you’ve been having as well as any questions for the practitioner.

Will Insurance Cover Telehealth for Eye Health?

With the rise of COVID-19, the U.S. government expanded telehealth coverage for Medicare and Medicaid recipients during this time. While this was originally available only in certain areas of the country, some coverage was extended nationwide during the pandemic. However, keep in mind there remains a 20% portion that remains your responsibility. Also, if you have private insurance, you should call to determine if telehealth visits are included and if this extends to eye examinations for glaucoma, cataract, or common infections like pink eye. If you are not covered for telehealth or have no insurance, there is also the option of contacting a private company that offers telehealth appointments with their practitioners for an out-of-pocket fee.

What Happens During the Visit

If you opt for the telehealth approach, you may be placed in a virtual waiting room once you open the link. Once the eye care professional admits you, they will likely ask you a series of questions to get a better idea of your eye needs.

In general, be prepared for them to ask you things such as:

  • Why did you request the appointment?
  • Can you describe your symptoms and how these began?
  • Have you ever had this condition before?
  • What have you done so far to eliminate symptoms and how has this worked?

More specifically, if you're concerned about an infection like pink eye, or contending with glaucoma or cataract, you can expect the eye care professional to home in on these.

Pink Eye

In cases where you are calling about a new infectious condition such as pink eye, the eye care practitioner will use the camera of your device to get a better look at the eye and will likely ask you to get the eye close to the screen.

They may ask you to shine a light on your eye so they can see this better.

If they believe this is infectious pink eye, they will ask key questions to try to determine whether it is bacterial, viral, or some less common type. For example, they will likely ask you if you recently had a virus-related upper respiratory infection such as measles or flu. If so, that likely means a case of viral pink eye.

The eye care practitioner will then discuss a treatment plan that may include a mix of palliative warm compresses and any drops that they may prescribe after the telehealth visit.

Glaucoma

For those who are looking to follow up on their glaucoma with a telehealth exam, come prepared to discuss any changes in your vision or pain you may be having. You can expect your health professional to potentially measure your visual acuity and examine the external part of the eye.

If you have remote eye pressure monitoring equipment such as the iCare system (iCare USA, Raleigh, NC), be prepared to discuss the results. They may go on to discuss possible changes in your medication, as well as detail future surgical options for you to consider.

If you do not have access to a system like that, your eye care professional may ask you to gently press on the eye and tell them whether it's somewhat pliable or extremely hard to the touch.

This will at least give them a rough idea of what your eye pressure is and whether medication or other adjustments need to be made.

Cataract

If you know you have a cataract or think you may be developing one, the eye care practitioner can get an idea of what is going on with a telehealth visit. With such a remote visit, they can check your vision and how this may have changed.

To roughly test vision, they may ask you to cover one eye and count the fingers of someone else nearby or to use an at-home vision test if you are able. They may also use the camera from your smartphone to see if they can detect any signs of a whitish opacity in the eye.

The eye care professional may also ask you questions about how the eye feels and how you are faring day to day. They can then discuss if it appears that you may have a cataract and if it has reached the point that this needs to be handled in person.

A Word From Verywell

Telehealth is proving to be a remarkable aid in minimizing the need to visit eye care professionals in person during this unique time. In many ways, it is offering an unparalleled look into what is possible. Given its growing appeal and acceptance, it would not be surprising if such visits continue to be commonplace long after COVID-19 is behind us.

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Article Sources
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