Teleophthalmology for Retinal Disease Screening and Referral in Low- and Middle-Income Countries: A Case Overview of India.

Innovations like teleophthalmology have made great strides in improving access to care for patients with retinal disease by enabling prompt screening and referral, especially in underprivileged areas. This review highlights the growing role of teleophthalmology in addressing the burden of few retinal diseases like diabetic retinopathy (DR), age-related macular degeneration (ARMD), and retinopathy of prematurity (ROP), artificial intelligence (AI), electronic medical records (EMR) and portable imaging technologies have greatly increased the precision of detection and care coordination. Its scalability is further supported by high patient satisfaction and cost-effectiveness. Barriers to implementation, however, include inadequate training, data security concerns, limited infrastructure and upfront investment costs. We offer focused solutions to address existing gaps, drawing primarily on evidence and national teleophthalmology initiatives from India, which is presented as a representative LMIC case study. The findings may guide the development and scale-up of teleophthalmology services in other LMICs settings. Teleophthalmology can become the backbone of equitable retinal disease care delivery with appropriate policy support and standardization of processes involved. These findings have broader implications for teleophthalmology implementation in LMICs that face similar healthcare delivery challenges.