This study evaluates the usage of tele-neuro-ophthalmology one year into the pandemic.

Tele-neuro-ophthalmology emerged as a resource early in the COVID-19 pandemic. Since then, telehealth utilization has evolved.

Telehealth utilization pre-COVID-19, early pandemic (March, 2020), and 1 year later (March, 2021) was surveyed among practicing neuro-ophthalmologists in and outside the United States using an online platform. Demographics, utilization, perceived benefits, barriers, and data utility opinions were collected over a two-week period in May 2021, prior to the emergence of the Delta and Omicron variants.

135 practicing neuro-ophthalmologists (81.5% United States, 47.4% females) participated in the survey. One year into the pandemic, the proportion of respondents utilizing video telemedicine (50%) decreased from early-pandemic rates (65%) (p<0.0005, McNemar), but was sustained above pre-pandemic percentages (6%, p<0.0005, McNemar). 82% of current video users plan to continue video visits. Proportion of respondents using remote testing (42.2% vs 46.2%, p=0.45), virtual second opinions (14.5% vs 11.9%, p=0.38), eConsults (13.5% vs 16.2%, p=0.25), online portal communications, and remote interpretation of patient-submitted testing remained similar between March 2020 and 2021. The majority selected increased access to care, better continuity of care, and enhanced patient appointment efficiency as benefits, while reimbursement, liability, disruption of in-person clinic flow, limitations of video exams, and patient technology use were barriers. Many neuro-ophthalmic exam elements were deemed more suitable collected in a separate in-person visit rather than during a live video session, although respondents felt some exam components could be evaluated adequately via a virtual platform.

One year into the COVID-19 pandemic yet prior to the emergence of the Delta and Omicron variants, neuro-ophthalmologists have maintained telemedicine utilization at rates higher than pre-pandemic levels. Tele-neuro-ophthalmology remains a valuable tool in augmenting patient care.