Telehealth for ophthalmology visits: What parents should know

By Dr. Rahul Bhola, pediatric ophthalmologist and medical director of ophthalmology at CHOC Children’s

Like many physicians continuing to offer care during the COVID-19 pandemic, I have transitioned many appointments to telehealth, so patients can still get the care they need while practicing social distancing. At CHOC Children’s, we adjusted our policies and practices to maintain a safe environment for our patients and families who need in-person appointments.

For in-person appointments, we require masks and practice proper hand hygiene to protect the health of everyone we serve. Before entering our building, CHOC nurses screen all visitors and staff. Screenings include a temperature check and asking symptom and exposure-related questions. In line with CHOC’s limited visitor policy during the COVID-19 pandemic, only one parent/guardian may accompany the child for their appointment. Our clinic is taking other necessary precautions such as thoroughly disinfecting clinical areas and rearranging seating in our lobby to ensure social distancing.

Since March, my office has successfully completed over 900 telehealth visits, on top of non-elective in-person appointments.

dr-bhola-choc
Dr. Rahul Bhola, pediatric ophthalmologist and medical director of ophthalmology at CHOC Children’s

Since telehealth is new to many families, here’s an overview of what parents can expect at their first virtual appointment, plus answers to parents’ most common questions on telehealth for ophthalmology.

A synchronous (live audio-video) CHOC ophthalmology telehealth appointment is divided into four components. I call them the four C’s: Contact, Connect, Consult and Care.

  1. Contact
    Our front desk reaches out to the family to confirm their contact information. We send a Zoom link to the family, along with information about how to connect to Zoom and download a Visual Acuity app that we use during appointments to check vision.

 

  1. Connect
    As the appointment day approaches, our technician connects with the family to resolve any technical issues before the physician consultation. The technician also goes over the at-home visual acuity check and evaluates basic medical history.

 

  1. Consult
    On the actual day of the telehealth appointment, the physician connects with the family to go over the relevant medical history and visual acuity and performs focused examination including external and ocular motility exam. If needed, pictures and videos from the family can be sent to the physician for further evaluation. This enables us to diagnose a majority of anterior segment ocular issues, visual acuity concerns like amblyopia, refractive errors and ocular motility disorders.

 

  1. Care
    During the telehealth appointment, we discuss the treatment care plan and review any medical issues or concerns the patient is experiencing. Throughout this process, we can fulfill their needs ranging from prescription refills or broken glasses, without them having to step outside the comfort of their home.

Our office will then schedule a follow-up visit depending on the medical necessity.

How do your patients and families feel about telehealth?

I have found that many patients love telehealth! Our families feel supported and secure, since there was no interruption in their child’s care plan. I’ve also found that our families feel grateful that during this time of uncertainty, their physician was able to connect with them and address any urgent issues, and then follow them in clinic as needed.

Due to the positive response we have received from our families, we plan to continue offering telehealth appointments in the future.

Does telehealth compromise quality of care?

No. We carefully scrutinize the kind of visits that can safely be performed via telehealth without compromising on quality of care. If your ophthalmologist decides your child’s visit can safely be conducted via telehealth, rest assured your child will still receive the high level of care you’re used to receiving in person. After the telehealth appointment if we feel the need for an in-person appointment, we will work with our families to schedule that appointment promptly and safely.

Sometimes, an exam conducted via telehealth reveals something requiring an in-person appointment. In those cases, we work with our families to schedule appointments promptly and safely.

Ger more information on telehealth

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Tips for Buying Reading Glasses

Is buying new reading glasses for your child part of your back to school checklist? Glasses come in many shapes, sizes and prescriptions, and buying them can be a confusing process. Here are a few tips from our CHOC Kids Health resource that you can use while making your first purchase:

1. Lenses
• Thickness: The thickness of the lens depends heavily on the type of prescription your child has. If the prescription calls for thick lenses, it is important to keep the frames smaller in order to reduce the overall lens thickness. Smaller lens thickness also reduces the likelihood of distorted peripheral vision.
• Material: Children’s lenses should be made from Polycarbonate or Trivex (as opposed to glass), because they are the safest materials. In addition to being lightweight, they also offer protection against harmful ultraviolet rays.

2. Bridge Fit
• Ensuring that your child’s glasses have a proper bridge fit is crucial, because it will prevent the glasses from sliding down the nose. Your optician will be the best judge as to whether glasses have a proper bridge fit.

3. Frames
• The frames for children’s glasses are usually made  out of plastic or metal. Plastic frames tend to be lighter and more durable, but many manufacturers are making metal frames with similar advantages. Children under the age of two should wear plastic frames. For older children that might wear metal frames, make sure that they have spring hinges, because it makes them more durable.
• Be sure to ask your optician for a hypoallergenic frame material if your child has shown sensitivity to different substances or alloys.

4. Style
• This may be just as important as every other feature – make sure your child likes the style of the glasses! Since he or she has to wear them every day, it’s important that the child feels a level of confidence while wearing them.

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