External eyelid, eyebrow and other conditions ideally suited for remote care

KauhOculoplastic care for patients at The Ohio State University Wexner Medical Center is thriving during the COVID-19 pandemic thanks to the implementation of telemedicine. People with eyelid, eyebrow and other conditions surrounding the eye have had the benefit of effective evaluations with the aid of live audio-video (or synchronous) telehealth, easy access, maintaining social distancing and high-quality care. 

When the pandemic struck the U.S. in early 2020, Courtney Kauh, MD, worked with colleagues to quickly mobilize and offer telemedicine care options. Dr. Kauh has completed a certified fellowship in oculoplastics through the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) and she is board certified in ophthalmology. She and her colleague have extended the reach of their oculoplastics expertise by continuing to offer a significant percentage of patient visits via live audio-video telemedicine and phone consultations. 

“I have found telemedicine to be most useful in evaluating patients with eyelid lesions,” Dr. Kauh says. “From our telemedicine visit, we are able to obtain prior authorization (from insurance) so a procedure can be scheduled without an in-person visit. For patients with concerns for possible skin cancer, telemedicine has allowed for more urgent care and coordination while minimizing social exposures in a clinic setting. For patients who have eyelid lesions like chalazia, I can provide medical advice and education, and prescribe medications or ointments as appropriate from the video exam findings and patient symptoms.” 

She also has successfully evaluated patients who have eyelid malposition and patients with droopy eyelids. In addition, for those patients who require surgery, the education and thorough discussions on preoperative testing and postoperative care, risks and benefits have been successfully communicated by telehealth, as well.

Advantages and limitations

“Within our Ophthalmology Department, telemedicine has been most advantageous for the Division of Oculoplastics, as many of the diseases we treat are visible externally and can be observed with external lighting,” Dr. Kauh says. She adds that she's able to serve patients who are at high risk for COVID-19-related complications with the use of telehealth in the safety of their homes. Furthermore, she's also been able to provide needed care by telehealth to patients who are COVID-19-related without bringing them into the office.  

Disadvantages of telemedicine, Dr. Kauh notes, are its limited use for patients who do not have access to broadband technology. “Telemedicine often requires access to high-speed Internet with camera capabilities, and without this, the ability to evaluate patients is very limited by telephone.

“Additionally, our area of expertise involves a small area of the body, around the eyes (and not in the eye). At present, telemedicine doesn’t allow us to examine very small or microscopic structures around the eye or to perform dynamic and 3D measurements of eye structures and functions.”

Dr. Kauh sees value in telemedicine beyond the pandemic. “Telemedicine will continue to benefit patients by increasing health care access for those who live far away, who have transportation limitations or have severe health problems that make it difficult to come in for office visits.”

For more information, call 614-293-8760.

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