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Background: Lions Outback Vision provides a telehealth service ('the telehealth service') to rural and remote communities in Western Australia aiming to deliver timely ophthalmic care to this underserved population. A number of barriers to its use were identified by an initial prospective audit. A multifaceted intervention was designed to increase the use of the telehealth service by optometrists.Methods: Optometrists referred patients from rural and remote Western Australia to the telehealth service. Two five-month prospective audits of the telehealth service were compared. The first, in 2012, was prior to the implementation of the intervention. The second, in 2014, was during the period of the intervention, which included logistical support, remuneration to optometrists, a more user-friendly referral pathway and awareness raising. The outcome measures were the number of consultations conducted during the two audit periods and other quantitative changes to the telehealth service.Results: After implementation of the intervention, use of the telehealth service increased 3.5 fold. A greater percentage of referrals were for non-urgent conditions (145 [69 per cent] versus 16 [32 per cent], p < 0.001) and less consultations recommended follow up with an ophthalmologist in clinic (42 [20 per cent] versus 17 [28 per cent], p = 0.04). Imaging studies were frequently used to supplement information provided by the referrer to the specialist during both audit periods.Conclusions: Optometrists used the telehealth service more frequently after the implementation of an intervention that addressed the barriers to its use. This has a number of potential benefits to rural and remote ocular health service provision in Australia. [ABSTRACT FROM AUTHOR]

Background: Cataract surgery is the most frequently performed ophthalmic procedure worldwide. While benefits gained from cataract surgery outweigh surgical risks, there have been concerns that older persons may have an increased risk of developing age-related macular degeneration (AMD) after cataract surgery. Objective: The Australian Prospective Study of Cataract Surgery and Age-Related Macular Degeneration Study aims to assess the risk of AMD in a large cohort of older patients following cataract surgery. The current report describes the study rationale, design and methodology. Design: Longitudinal studyParticipants: Approximately 2000 cataract surgical patients aged 65 years or older are being recruited from both public and private sources in western Sydney, Australia.Methods: At study visits, participants are interviewed using standardized questionnaires to obtain information on demographic, medical, and ocular conditions and AMD risk factors, together with data on general health and vision-related quality of life. Eye examinations include visual acuity, intraocular pressure, keratometry and A-scan measurements, plus lens and retinal photography, following pupil dilatation. Retinal photographs taken before cataract surgery, and at 1, 6, 12, and 24 months after surgery are graded for early and late AMD lesions, using the Wisconsin age-related maculopathy grading system. The 1-month post-operative retinal photographs supplement the baseline macular assessment for cases in which cataract occludes a clear view of the macula pre-operatively. It is intended that study participants will be followed for up to five years post-operatively to clarify the question of whether aphakic or pseudophakic, compared to phakic eyes, have a greater risk of developing AMD. [ABSTRACT FROM AUTHOR]