A Novel Virtual Cataract Clinic Protocol With Anterior And Posterior Segment Imaging - A Complimentary Solution To Meet Increasing Demand For Cataract Services

To evaluate the outcomes of a novel virtual cataract clinic protocol with anterior and posterior segment imaging.

Tertiary referral centre at Moorfields, St George’s Hospital, London

Patients attended a diagnostic clinic where all necessary assessments/investigations, including anterior segment photography, macular optical coherence tomography (OCT) and widefield fundus photography, were performed by technicians based on our protocol. Patients then attend a remote telephone/video virtual clinic with a clinician where the digital data was reviewed and a full cataract consultation conducted prior to attending for surgery. A retrospective analysis was performed on the clinical outcomes and duration of the appointments, the safety of the protocol, and on patient satisfaction.

A total of 329 virtual clinic appointments were offered which led to 197 telephone consultations (59.9%), 92 video consultations (28.0%) and 40 did not attends (DNAs) (12.1%). A total of 244 eyes were listed for surgery, 174 operations were performed with no safety incidents, and the remainder await surgery. The mean duration of each appointment was 17.96 minutes (SD 7.13). Of those on the virtual clinic pathway, 48 (14.6%) had non-cataract pathology necessitating referral to another subspecialty, and 36 (10.9%) required referral to a face-to-face cataract clinic (22 of these 36 were due to administrative booking errors). 96.3% of patients surveyed were very satisfied with the pathway and only 0.7% preferred face-to-face consultations.

Our virtual pathway revealed no safety issues, increased patient throughput by 50% compared to standard face-to-face clinics and had overwhelming positive feedback from patients. By improving access, reducing waiting times, and enhancing efficiency, our protocol provides high-quality cataract care and helps to cope with increasing service demand in a flexible manner, all whilst meeting modern safety standards and providing a long-lasting positive impact on sustainability by reducing carbon emissions from patient and staff commutes. Future directions include incorporating the use of electronic consent platforms and harnessing the potential of artificial intelligence (AI) to automate decision-making and streamline workflow.