The use of telemedicine to support Brazilian primary care physicians in managing eye conditions: The TeleOftalmo Project

PLoS One. 2020 Apr 2;15(4):e0231034. doi: 10.1371/journal.pone.0231034. eCollection 2020.


Purpose: To determine whether teleophthalmology can help physicians in assessing and managing eye conditions and to ascertain which clinical conditions can be addressed by teleophthalmology in primary care setting.

Methods: We evaluated the resolution capacity of TeleOftalmo, strategy implemented in the public health system of southern Brazil. Resolution capacity was defined as the ability to fully address patients' eye complaints in primary care with remote assistance from ophthalmologists. Data from tele-eye reports were collected over 14 months. Resolution capacity was compared across different age groups and different ocular conditions.

Results: Overall, 8,142 patients had a tele-eye report issued in the study period. Resolution capacity was achieved in 5,748 (70.6%) patients. When stratified into age groups, the lowest capacity was 43.1% among subjects aged ≥65 years, while the highest was 89.7% among subjects aged 13-17 years (p<0.001). Refractive error (70.3%) and presbyopia (56.3%) were the most prevalent conditions followed by cataract (12.4%) and suspected glaucoma (7.6%). Resolution capacity was higher in cases of refractive error, presbyopia, spasm of accommodation and lid disorders than in patients diagnosed with other condition (p<0.001).

Conclusions: With telemedicine support, primary care physicians solved over two-thirds of patients' eye or vision complaints. Refractive errors had high case resolution rates, thus having a great impact on reducing the number of referrals to specialty care. Teleophthalmology adoption in primary-care settings as part of the workup of patients with eye or vision complaints promotes a more effective use of specialty centers and will hopefully reduce waiting times for specialty referral.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Ophthalmic
  • Adolescent
  • Adult
  • Brazil
  • Cataract / diagnosis*
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ocular Hypertension / diagnosis*
  • Ophthalmology / methods
  • Physicians, Primary Care
  • Primary Health Care
  • Referral and Consultation
  • Refractive Errors / diagnosis
  • Telemedicine
  • Visual Acuity / physiology
  • Young Adult

Grant support

This work is based on research supported by Hospital Moinhos de Vento and the Program of Support for the Institutional Development of the Unified Health System (PROADI-SUS) (Website: The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.