Physicians, Patients Mostly Satisfied With Virtual Visits in Neuro-Ophthalmology Survey

The COVID-19 pandemic has brought telemedicine to the forefront as a mechanism of conducting certain medical visits.

Many patients and neuro-ophthalmology physicians expressed that they were satisfied with the care conducted in these virtual health visits, researchers found in a study they presented at the North American Neuro-Ophthalmology Society’s 2021 Annual Meeting.

Since neuro-ophthalmology depends on physical exams more than some other medical fields, the researchers sought to understand whether patients and physicians were satisfied with the experience during the peak of the COVID-19 pandemic in the spring of 2020.

They surveyed 159 patients and 157 neuro-ophthalmologists regarding single patient visits at 3 institutions: NYU Grossman School of Medicine, Indiana University Health, and Columbia University Medical Center.

They asked patients about the difficulty of understanding instructions to attend the virtual visit, whether they believed that the visit was sufficient compared with an in-person visit, whether there were challenges or ways to better prepare for the visit and comfort level of asking health questions over a virtual visit compared with an in-person visit. 

Of the 159 patients surveyed, 104 were satisfied with the visit and 149 felt “very comfortable” asking questions. Of the 92 patients who answered the question regarding understanding instructions to prepare for the visit, 68 said the instructions were “very easy” to understand while 17 said the instructions were “somewhat easy” to understand.

Areas of improvement included more detailed preparation instructions and better technology opportunities (such as phone positioning, internet connection, and software).

The neuro-ophthalmologists were asked whether the virtual health visits provided enough information for medical decision-making and which parts of the exam they found “surprisingly easy” to gather useful information from. They were also asked whether there were methods that could enhance their ability to gather information virtually and how many virtual health visits they had performed by the time they took the survey.

The majority (137) of the surveyed providers said the visit and examination provided sufficient information for decision-making. The exam portions most noted as “surprisingly easy” included range of eye movements (126), visual acuity (117), Amsler grids (91), Ishihara colors plates (79), and red desaturation (56). The more difficult to conduct exams were pupil exam, saccades, convergence, oscillations, and smooth pursuit eye movements. Neuro-ophthalmologists said the areas of examination that were especially challenging were ocular alignment, visual fields, vistibulo-ocular reflex (VOR), VOR suppression, and optokinetic nystagmus.

Limitations of the exams included patient preparation, inability to perform funduscopic and pupillary exams, and technological issues. Technology and better instructions may improve some aspects of virtual exams.

Reference

Krieger P, Conway J, Hasanaj L, et al. Telemedicine evaluations in neuro-ophthalmology during the COVID-19 pandemic: patient and physician surveys. Presented at: North American Neuro-Ophthalmology Society Annual Meeting; February 20-23, 2021; Poster 69.