Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2025
Pediatric teleophthalmology screening: a scoping review of global evidence and implications for Canada.
Scoping ReviewСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Sachdeva Kyran, Turcios Michelle, Solarte Carlos Eduardo
Аннотация
BACKGROUND: In Canada, nearly 90% of children under 6 have never received a comprehensive eye exam, despite national guidelines recommending at least 1 before age 5. Missed diagnoses of amblyopia, strabismus, and retinopathy of prematurity (ROP) contribute to preventable vision loss and inequities.
OBJECTIVE: To synthesize evidence on pediatric teleophthalmology screening, evaluating performance, feasibility, and economic considerations, with attention to relevance in the Canadian context.
METHODS: A scoping review was conducted in Ovid MEDLINE, EMBASE, CINAHL, and Scopus (2005-2025) for studies assessing teleophthalmology screening in children. Screening was performed in duplicate, with data extracted on modalities, conditions, settings, and costs.
RESULTS: Of 3 752 identified studies, 30 met inclusion criteria, involving >15,000 children. Digital retinal imaging (n = 18), video (n = 7), and smartphone-based tools (n = 5) demonstrated diagnostic performance comparable to gold-standard in-person exams in most reports. Cost-analysis studies consistently found teleophthalmology to be more cost-effective than in-person screening. Barriers included equipment costs, staff training, and poor connectivity in rural areas; facilitators included reduced costs and expanded screening capacity. Evidence gaps remain for non-ROP conditions (e.g., amblyopia, strabismus, retinoblastoma) and for rural, low-resource, and Indigenous populations.
CONCLUSIONS: Teleophthalmology shows promise for expanding pediatric vision screening capacity and accessibility in Canada. However, Canadian validation studies are limited. Implementation research focusing on rural and Indigenous communities, non-ROP conditions, and patient-centered outcomes is urgently needed to guide equitable integration into pediatric eye care.
OBJECTIVE: To synthesize evidence on pediatric teleophthalmology screening, evaluating performance, feasibility, and economic considerations, with attention to relevance in the Canadian context.
METHODS: A scoping review was conducted in Ovid MEDLINE, EMBASE, CINAHL, and Scopus (2005-2025) for studies assessing teleophthalmology screening in children. Screening was performed in duplicate, with data extracted on modalities, conditions, settings, and costs.
RESULTS: Of 3 752 identified studies, 30 met inclusion criteria, involving >15,000 children. Digital retinal imaging (n = 18), video (n = 7), and smartphone-based tools (n = 5) demonstrated diagnostic performance comparable to gold-standard in-person exams in most reports. Cost-analysis studies consistently found teleophthalmology to be more cost-effective than in-person screening. Barriers included equipment costs, staff training, and poor connectivity in rural areas; facilitators included reduced costs and expanded screening capacity. Evidence gaps remain for non-ROP conditions (e.g., amblyopia, strabismus, retinoblastoma) and for rural, low-resource, and Indigenous populations.
CONCLUSIONS: Teleophthalmology shows promise for expanding pediatric vision screening capacity and accessibility in Canada. However, Canadian validation studies are limited. Implementation research focusing on rural and Indigenous communities, non-ROP conditions, and patient-centered outcomes is urgently needed to guide equitable integration into pediatric eye care.