Accuracy of periocular lesion assessment using telemedicine
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  • Published on:
    Clinical governance issues with telemedicine for periocular lesion assessment
    • Jennifer Hind, Ophthalmology Registrar Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow
    • Other Contributors:
      • Vikas Chadha, Consultant Ophthalmologist (Oculoplastics and Ocular Oncology)

    We read with interest the published study “Accuracy of periocular lesion assessment using telemedicine” [1]. The authors correctly identify a paucity of evidence for image-based triage or management of minor lid complaints, which has become an attractive option for reducing footfall in the oculoplastics clinic in the current situation. We have had a similar experience to the authors with the translation of our “one-stop” minor lids clinic into an image-based initial virtual assessment. We performed a pilot study to ascertain whether we could achieve diagnostic accuracy with images and a brief history that demonstrated agreement between a face-to-face and remote review (paper currently under peer-review) similar to this published study.

    Although demonstrating diagnostic accuracy is important in the development of this service, ensuring safety is a critical clinical governance area and should be addressed while rolling out such a service. Skin cancer referrals were excluded from this published study. While skin cancers are not routinely seen in a minor lids clinic, these are occasionally diagnosed in this setting especially if the referral does not have adequate information. In our cohort of 97 patients seen in the ‘minor operations’ clinic, 8 malignancies (basal cell carcinomas) were identified. These were all flagged up by the virtual assessment. The fact that none of the malignant lesions were missed in our cohort is very encouraging in terms of safety of...

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    Conflict of Interest:
    None declared.