A current status of teleophthalmology in low- and middle-income countries: literature review

Background: Teleophthalmology is being actively implemented in developing countries. Using sound information and communication technology (ICT), it has been significantly improving service provision in the field of eye health such as screening for diabetic retinopathy (DR), which can be prevented by early diagnosis and treatment even in resource limited settings. This study is exploring the usability of teleophthalmology in Lowand Middle-Income Countries (LMICs) while systematically reviewing how it is adopted to each domain and eye diseases. Methods: The study searched for all literature regarding teleophthalmology in LMICs using PubMed, Cochrane Library, and Google Scholar published from January of 2005 and October of 2017. Two independent researchers found 362 literatures, and 67 articles were finally selected through sets of criteria including PRISMA method. Results: The study identified 26 articles for DR, 10 for retinopathy of prematurity, and 31 for the rest of the eye diseases. LMICs account the most with 36 articles. The most widely used technical domain for teleophthalmology was ‘sensor and point of care diagnostics,’ which depicts the device-dependent-characteristic of teleophthalmology. When the stage of the research is postpilot, the most widely used technical domain became ‘provider to provider communication.’ Conclusion: A major part of Teleophthalmology is providing services through mobile or portable devices. We also found that application of teleophthalmology is more active where there is firm social infrastructure for ICT.