First Clinical Experience With Ophthalmic e-Device for Unaided Patient Self-Examination During COVID-19 Lockdown.

PURPOSE: The aim of this study was to describe a new type of medical device that allows for internet-enabled patient self-screening, without the aid of an ophthalmic professional, through biomicroscopy self-imaging and self-measurement of the best-corrected visual acuity (BCVA). METHODS: In this prospective nonrandomized comparative study, 56 patients were instructed to screen their own eyes using a custom-built e-Device containing miniaturized slitlamp optics and a visual acuity Snellen chart virtually projected at 20 ft. BCVA measurements were recorded, and biomicroscopic videos were scored for image quality of the anterior segment status on a scale from 1 to 5 (1 = poor and 5 = excellent) by a blinded observer. RESULTS: After a short instruction, all patients were able to self-image their eyes and perform a self-BCVA measurement using the e-Device. Patient self-image quality with the e-Device scored on average 3.3 (±0.8) for videos (n = 76) and 3.6 (±0.6) for photographs (n = 49). Self-BCVA measurement was within 1 Snellen line from routine BCVA levels in 66 of 72 eyes (92%). When compared with conventional biomicroscopy, patient self-biomicroscopy allowed for recognition of the relevant pathology (or absence thereof) in 26 of 35 eyes (74%); 9 cases showed insufficient image quality attributed to device operating error (n = 6) and mild corneal edema and/or scarring (n = 3). Patient satisfaction with the device was 4.4 (±0.9). CONCLUSIONS: An e-Device for combined BCVA self-measurement and biomicroscopy self-imaging may have potential as an aid in remote ophthalmic examination in the absence of an ophthalmic professional and may be considered for patients who are unable to visit an ophthalmic clinic for routine follow-up.

Patient Experience With Office-Based Corneal Transplantation.

PURPOSE: To evaluate patient experience with office-based corneal transplantation. METHODS: Five hundred sixty-seven consecutive patients had a corneal transplant in a stand-alone operation unit, ie, a unidirectional flow hood inside a dedicated treatment room in an office setting. Six months postoperatively, all patients received a questionnaire inquiring how they experienced corneal surgery and the operation unit; 354 patients responded to the questionnaire and their answers were scored on a scale of 1 to 5, with higher scores indicating greater satisfaction. RESULTS: The average score to the question "How would you rate your experience of your corneal operation in general?" was 4.4 ± 0.62 (n = 354), and the average score to the question "How would you rate your experience within the operation unit, taking into consideration feelings of claustrophobia and how comfortable you felt?" was 4.1 ± 0.82 (n = 348). Patients who had undergone previous ocular surgery in a conventional operating theater scored their office-based corneal transplant no less favorably than those patients for whom it was their first operation (P = 0.9 and P = 0.77, respectively). Most subjective comments pertained to the surgical stretcher, rather than to the experience of office-based surgery in general or to the unidirectional flow hood in particular. CONCLUSIONS: Regardless of the ophthalmic surgical history, patient experience with office-based corneal transplantation was generally positive.