"Doctor, my right eye is a little red," said Mr Tan, 70, a glaucoma patient at the Singapore National Eye Centre (SNEC).
"Come closer," Professor Tina Wong, head and senior consultant at the centre's glaucoma department, instructed, leaning forward .
This sounds like a typical consultation, except it isn't. Mr Tan and Prof Wong are on a video call - a new mode of care that SNEC has started for its growing pool of glaucoma patients whose conditions are stable.
The redness is a side effect of eye drops, Prof Wong told Mr Tan, who did not want to reveal his full name. After reviewing some previously taken eye images, she said she would order more checks for him at the centre in about two months.
Telemedicine became a necessity at the SNEC and other healthcare institutions during the circuit breaker beginning on April 7, when face-to-face consultations were minimised to urgent cases.
Now, it may become a normal part of business. The SNEC aims to offer video consultations to 500 stable glaucoma patients by the end of the year, and another 3,600 next year.
About 15,000 stable glaucoma patients who typically make two visits a year, forming 60 per cent of all SNEC glaucoma patients, will eventually be able to access this service, if they are willing.
Glaucoma is one of the leading causes of blindness in people aged above 60 and is brought on when high fluid pressure within the eye damages the delicate fibres of the optic nerve.
Patients will still need routine tests, such as visual field exams and eye imaging, to be done at the SNEC and future satellite clinics. But follow-ups can be done via telemedicine, saving them the commute to the centre and waits to see the doctor and collect their medicines, which can be delivered to their homes.
The SNEC handles nearly three quarters of the glaucoma patients in Singapore. There are more patients now as the population ages.
"We have over 55,000 to 60,000 patient visits a year. From 2015 to 2019, we saw a 40 per cent increase in the number of visits to the SNEC for glaucoma. So, the load is growing, but the space is the same," said Prof Wong.
Care can be stratified according to disease severity, she said.
Telemedicine will allow the centre to better serve patients whose conditions are more serious and need to be seen in person, she said.
Prof Wong said telemedicine works well for glaucoma. "We do a lot of imaging for glaucoma to monitor the disease and its progression," she said. "Having good photographs of the front of the eye is as good as if I were to examine a patient physically here."
For now, like other specialist centres and hospitals, the SNEC is handling only urgent cases.
"We had 28 patients in the morning, when we normally see over 100," said Prof Wong. The SNEC expects to see a reduced number of patients going forward as safe distancing measures will still need to be observed.
In the near future, the SNEC also plans to offer telemedicine to selected patients with myopia, and corneal, retinal as well as neuro-opthalmology conditions.
"One of the things we will remember from Covid-19 is that it has made us all go into the digital transformation era because we have had to adapt in times of adversity," said Prof Wong.