PhD Defense: Telemonitoring in Ophthalmology

In this thesis, we explored the role of telemonitoring in ophthalmology. We have shown that a plethora of digital tools for vision self-assessments are available, yet also underlined the importance of research before adopting these tools in clinical practice. The most important clinical implications of vision self-assessments revolve around the subjectivity of VA testing, particularly the influence of external factors. Future self-assessment tools should focus on limiting the influence of these factors and providing information on performance adequacy. Another important lesson learnt is that the collection and representation of the data should be intuitive and easy-to-understand, for both patients and eye care professionals. 

Cataract surgery follow-up care is a promising area for telemonitoring, allowing patients to independently assess their vision and self-report surgical outcomes at home, while contributing to the data collection for quality control and benchmarking. This thesis marks the first steps and demonstrated that cataract patients are ready to embrace remote follow-up care. Improvements of existing technology and widespread support are crucial to make this a reality. Convincing eye care professionals, accustomed to traditional practices, poses a significant challenge. Large-scale studies performed in real-world conditions, and evaluated by independent research teams, should be at the cornerstone to achieve their support. Importantly, the studies focusing on clinical outcomes should be performed in parallel to stakeholder analyses and cost-effectiveness research. In the end, the development and implementation of digital health technology requires a holistic approach.