Distant Ophthalmic Triage System (DOTS)

眼科保健是初级卫生保健的重要组成部分，这反映在英国每年进行的1300多万次国民保健服务（NHS）视力检查中。但是，由于眼科常规检查无法保持社会距离，因此光学行业已经陷入停滞，而且很可能在很长一段时间内继续受到严重干扰。这种情况对该部门产生了严重的经济影响，而且，常规初级眼科保健的暂停可能造成大量眼病未被发现和未得到治疗，其中一些可能导致永久性视力丧失。英国国家医疗服务体系与英国眼科机构共同声明，需要提供紧急、紧急或必要的初级眼科护理。据建议，在可能的情况下，这项服务应包括远程分诊和电话或视频咨询；利用技术优势，尽量减少面对面的预约和病人与医生的接触时间。因此，必须设计出可以远程实施的眼科保健新方法。Optonet计划开发远程眼科分诊（DOT）系统，以协助验光师（眼科验光师）在封锁期间与可能出现眼部症状的个人进行远程会诊。DOT系统是一种创新的软件，可以在线访问，包括一套完整的与常见眼部症状相关的视觉分诊问题。一旦病人的回答被记录下来，该程序就会列出可能导致这些症状的潜在原因。此外，DOT系统将允许医生在患者拥有的任何电脑或平板电脑上远程显示高质量的可视化图表，以便收集一些重要的视觉数据。这是一项独特的新倡议。Optonet的DOTS还将使用安全的专用服务器在云中提供安全的记录保存。这解决了安全有序的记录保存问题（因为验光师可能在家工作），但它也简化了对数据的访问，以及与其他医疗保健专业人员交换临床信息。Optonet独特的创新方法可能有助于为公众恢复一定程度的初级卫生眼科保健，同时最大限度地降低Covid-19传播的风险。这一举措还可能极大地帮助光学部门在保持社会距离的条件下保持一定程度的经济活动。这也可以成为未来远程验光服务发展的第一步。皇家眼科学院和英国和爱尔兰眼科学会最近警告说，在远程咨询（在家庭环境中）使用未经适当验证的图表是有风险的；并建议在采用它们进行健康评估之前要谨慎。扩大影响资助将使Optonet能够在临床环境中对远程标准化DOTS的视力表与金标准视力表进行验证研究。Optonet的目标是在同行评议的期刊上发表有史以来首次验证眼科远程会诊图表的研究之一。获得学术和科学的信任肯定会加快我们项目的上市速度，并有助于其传播，这反过来又会影响提高公众远程眼科咨询的质量。这个扩展也将允许系统的beta测试，并找到未来的合作伙伴。

Eye care provision is an essential part of primary health care, which is reflected in the over 13 million national health service (NHS) sight tests performed in England every year.However, the optical sector has been halted by the Covid-19, and is likely to continue to be severely disrupted for a long time, since social distancing cannot be maintained during routine eye examination. This situation is having a severe economic impact on the sector, but moreover, the suspension of routine primary eye care poses a risk of a large number of eye conditions being left undetected and untreated, some of which may result in permanent visual loss.NHS England, together with the UK Optical bodies, have stated the need to provide urgent, emergency, or essential primary eye care. It has been advised that, where possible, this service should include remote triage and consultations by telephone or video; taking advantage of technology to minimise face-to-face appointments and patient -- practitioner contact time.It is thus imperative to devise new approaches to eye health care that can be implemented remotely. Optonet projects the development of a Distant Ophthalmic Triage (DOT) System to assist optometrists (ophthalmic opticians) during remote consultations with individuals who may experience ocular symptoms during the lockdown.The DOT system is an innovative software that can be accessed online and comprises a thorough set of visual triage questions related to common ocular symptoms. Once patient answers are recorded, the program will suggest a list of likely underlying causes for those symptoms.In addition, the DOT system will allow the practitioner to display high-quality visual charts remotely on any computer or tablet owned by the patient, in order to collect some essential visual data. This is a unique new initiative.Optonet's DOTS will also offer safe record keeping in the cloud, using a secure dedicated server. This sorts the problem of safe and organized record keeping (as optometrists may work from home), but it also simplifies access to data, and the exchange of clinical information with other health care professionals.Optonet's unique innovative approach may help restoring some degree of primary health eye care for the general public, whilst minimizing the risk of Covid-19 transmission. This initiative may also significantly help the optical sector to keep some degree of economic activity during social distancing conditions. It can also be the first step towards the development of a future Tele-Optometry service.The Royal College of Ophthalmologists and the British and Irish Orthoptic Society have recently warned on the risks of using charts that have not been properly validated, during remote consultations (in home settings); and recommend caution before adopting them for health assessments. The Extension for Impact funding will allow Optonet to carry out validation studies of the remote standardised DOTS’ vision charts against gold standard charts in clinical settings. Optonet aims at publishing one of the first ever studies to validate charts for ophthalmic remote consultations, in peer-reviewed journals. Gaining academic and scientific trust will definitely increase speed to market for our project and will help its dissemination, which will, in turn, impact in improved quality of remote ophthalmic consultations to the public. This extension will also allow beta testing of the system and to find prospective partners.