Systematic Review of Surveys Used to Evaluate Patient and Provider Perspectives on Teleophthalmology.

Background: Telemedicine has become an important mechanism for delivering health care in the wake of the COVID-19 pandemic. While some medical subspecialties were able to rapidly integrate telecare into their workflow, ophthalmology is one field in which telemedicine has not been as widely adopted. In this systematic review, we analyze published studies assessing patient and provider viewpoints on telemedicine for eye care. Our aim is to understand how adoption of teleophthalmology is being studied and whether definitive conclusions regarding patient and provider perspectives on telecare can be drawn from published literature. Methods: We performed a systematic PubMed search for studies utilizing surveys to assess patient and provider perspectives regarding remote eye care. Articles were excluded if they were irrelevant to teleophthalmology, did not assess patient or eye care provider perspectives regarding teleophthalmology, assessed specific platforms or aspects of eye care, were reviews without primary data, or if the survey used was not available. The questionnaires from the included articles were analyzed for validation status, subspecialty, question wording, and response format. Results: The PubMed search returned 92 articles, 22 of which were included in the final dataset after exclusions. Only four studies utilized externally validated questionnaires, although several additional studies were based on validated items. Survey length, wording, and response formatting varied across the studies. These 22 studies contained responses from 3,796 patients and 2,388 eye care professionals, but the lack of standardization between the surveys makes high power conclusions impossible. Discussion: The results of this review demonstrate a need to develop a standardized and validated survey instrument specifically for assessing teleophthalmology to identify barriers to widespread implementation.