Telehealth Robots Deliver Quality Patient Education in Glaucoma

Photo taken in Bangkok, Thailand
Research shows the automated process is as effective as in-person sessions.

Telehealth technologies can deliver one-on-one patient education following an office visit or serve as a HIPAA-compliant, socially-distant alternative to in-office education sessions. To evaluate their usefulness, researchers compared the effect of education sessions given by an in-person educator vs those delivered via a telehealth robot and reported their findings in the Journal of Glaucoma. The results show telehealth robots provide a safe and relatively effective method for educating outpatients. 

According to researchers, poor glaucoma treatment adherence rates are associated with a lack of knowledge about the condition. While in-person teaching sessions are an excellent method of educating patients, it requires time and resources. In communities that lack the resources for in-person education sessions, telepresence robots (TRs) can safely deliver direct, real-time education, according to investigators. Additionally, COVID-19 safety protocols may prevent in-person learning.

Via a video conferencing system mounted on a mobile robotic base, educators can deliver educational content to patients affected by glaucoma remotely from any location. But is remote learning as effective as in-person education? To investigate this question, researchers divided 85 patients with glaucoma into control, human, and robot groups. The group’s mean age was 58.3 ± 2.8 years, and 49% of the study’s participants were female. Glaucoma knowledge scores (KS) were measured using the National Eye Institute’s Eye-Q Test.

The human and robot groups had the education sessions with either a human or robot, then completed the Eye-Q questionnaire. The control group was administered the questionnaire without an education session. Treatment regimen recall (RR) greater than 90% was considered successful. Investigators used linear regression and binary logistic regression to determine the variables that affect KS and RR. Mean KS were 5.8 ± 0.7 in the control group (n=31), 7.9 ± 0.5 in the robot group (n=26), and 8.4 ± 0.5 in the human group (n=28). Control participants had a lower mean KS than the human or TR groups (P <.001). Having the education session (2.5, P <.001), education beyond high school (0.8, P =.016), and diabetes (−0.7, P =.037) all affected KS. Having diabetes (odds ratio=0.14, P =.014) negatively affected RR. Having the education session may affect RR (odds ratio=5.47, P =.07), warranting additional studies, the researchers note.

“Our results suggest that interactive education sessions with either a human or a TR improved patients’ glaucoma knowledge and treatment RR,” says the study’s authors. “Since there was no statistical difference between education sessions given by an in-person educator or a TR, TRs may serve as an alternative to in-person education sessions.”

To improve patient outcomes, glaucoma educators should focus on the irreversible and often silent course glaucoma takes as well as its risk factors, according to researchers.

The study’s limitations include its small sample size and the potential for self-selection bias since participants controlled whether they participated in the study. Third, the study didn’t analyze long-term knowledge retention and treatment regimen adherence. Lastly, the study did not evaluate the cost-effectiveness of implementing telepresence robots in a clinical setting.

Disclosure: One study author declared affiliations with the biotech or pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Ooms A, Shaikh I, Patel N, et al. Use of Telepresence Robots in Glaucoma Patient Education. J Glaucoma. 2021;30(3):e40-e46.. doi:10.1097/IJG.0000000000001731