Referring

Telemedicine

For 25 plus years Joan and I have consulted over the telephone on all sorts of eye cases. Sometimes the descriptions of eye lesions given to us on the ‘phone leave something to be desired –if you don’t spend all of your time looking at eyes some of the lesions can be very difficult to assess. This becomes evident if we get to see the case and realize that what you see and what we see can differ to quite some extent.

The cliché “a picture is worth a thousand words” could not by more appropriate when describing the value of our SEEING the eye in question. In many cases the referring veterinarian has a pretty good idea of what is going on but would like a little back up from a specialist. Some owners might be reluctant to be referred leaving you in a difficult position managing a troublesome eye case.

In years gone by there was little to be done about this – now however we have perhaps two of the greatest inventions since sliced bread – the digital camera and the internet! These give the referring veterinarian the opportunity to consult with a specialist, often in real time, on any many ophthalmic cases (certainly anything involving the anterior segment of the eye or the ocular adnexa).

The only requirement is that you have a digital camera and some familiarity with how to use it plus an internet connection. Our telemedicine basics page offers useful tips about how to photograph eyes and send images to CTVO for consultation.

What situations would benefit from a telemedicine consultation?

  • Cases where, after a period of treatment, the expected outcome has not been achieved and a second opinion is sought
  • Emergency cases where you are trying to decide (with the owner) whether this is a case you will be comfortable handling or whether you would rather have it see a specialist for workup and treatment
  • Cases where you feel all is going well but would like to have our opinion to re-assure the owner
  • Interesting cases you would like to share with us

For example:

  • Animals with severe ulcers are a challenge at the best of time. We have seen many over the years in which the question comes up – can this eye be saved? or, can this eye be saved without surgery? In most cases when we see the eye we can give an opinion based on our previous experience. Often an eye you might have given up on we would feel has a good chance of healing (with or without surgery). A photograph of the eye can allow us to determine whether you should keep treating the eye or whether the situation would benefit from referral to your local ophthalmologist.
  • We are often asked about cats with pigment changes in the iris – could these be benign pigmentation or something more sinister (maybe diffuse iris melanoma) – a telemedicine consultation and photograph of the eye will often allow is to give a better recommendation than when based on a verbal description.
  • What is going on in a red eye? Is it conjunctivitis, uveitis, glaucoma or what? - a photograph will enable us to point you in a particular direction regarding the diagnosis.

If you have any questions about sending us photos of particular eye cases – please send us e-mail or telephone us to alert us that you would like a telemedicine consultation.