The following is a summary of “How to assess blepharoptosis via telemedicine: method and its reliability,” published in the February 2024 issue of Ophthalmology by Zloto et al.
Researchers conducted a retrospective study to develop and evaluate a method for assessing adult ptosis via video consultation, focusing on the reliability of identifying blepharoptosis.
They conducted a retrospective, comparative case series by reviewing the surgical waiting list for ptosis surgery (between August 2020 and January 2021). Only cases scheduled for surgery via video consultation assessment, with no prior face-to-face consultation, were included. Data collected for patients who underwent video consultation before surgery included demographic information, clinician’s experience level, levator function, presence of Cogan’s twitch sign, fatigability test results, eye motility assessment, lagophthalmos presence, clinical history to exclude conditions like Myasthenia Gravis, other myopathies or Horner syndrome, surgery status (performed or canceled), reasons for cancellation, surgery date, type of procedure, and surgeon’s experience.
The results showed that of 176 patients who underwent ptosis surgery, 45 (25.6%) were assessed solely via video consultation before surgery, with 36 (80%) proceeding to surgery. Surgery was canceled in 20% of cases, with 2 cases (4.44%) attributed to misdiagnosis of ptosis during video consultation, confirmed during pre-surgical face-to-face assessment, and 7 cases (15.55%) where blepharoptosis was confirmed face-to-face but surgery was canceled for other reasons. Ptosis diagnosis via video consultation was corrected in 43 cases (95%) (P-value = 0.156, chi-square). The accuracy of ptosis diagnosis was 13 out of 15 (86.7%) by fellow assessments and 30 out of 30 (100%) by consultant assessments (P-value = 0.041, chi-square). The video consultation for ptosis assessment typically involved a rough evaluation of levator function, eye motility, and lagophthalmos signs.
Investigators concluded that video consultations are almost as accurate as in-person assessments for ptosis diagnosis, suggesting they could be a valuable tool for initial screenings.
Source: link.springer.com/article/10.1007/s10792-024-02926-z
