| Summary: | Nicolas Blais,1,* Benoit Tousignant,1,2,* Jean-Marie Hanssens1,* 1School of Optometry, Université de Montréal, Montréal, Québec, Canada; 2Department of Social and Preventive Medicine School of Public Health, Université de Montréal, Montréal, Québec, Canada*These authors contributed equally to this workCorrespondence: Nicolas Blais, School of Optometry, Université de Montréal, Montréal, Québec, Canada, Tel +1-418-215-2741, Email nicolas.blais.1@umontreal.caIntroduction: Proper access to primary eye care is essential in addressing vision impairment, and tele-eye care examinations are a promising solution that could facilitate this access in many rural or remote areas. Even though remote eye exams are becoming increasingly frequent, comprehensive tele-eye care exams are still limited by the lack of published data. The aim of this study is to compare a comprehensive tele-eye care exam with a gold standard in-person primary eye care exam with an emphasis on refractive measurements, ocular health assessment, confidence level of the eye care providers and patient satisfaction.Methods: Sixty-six participants underwent two comprehensive eye exams performed by two eye care providers. One was a gold standard in-person exam, while the other was a remote exam performed by an eye care provider through videoconference. An overall patient satisfaction survey and a questionnaire for visual comfort with a trial frame from each modality were completed and the eye care providers scored their confidence level for each test. Exam results and diagnoses were compared between both modalities.Results: Tele-refraction has a good to excellent agreement with in-person subjective refraction in terms of sphero-cylindrical power and best corrected visual acuity. There was no statistically significant difference for visual comfort between both modalities. The agreement between in-person and remote exams for ocular health assessment ranged from fair to almost perfect, but there was a low prevalence of ocular pathologies within the study sample. The confidence level of the eye care providers and patient satisfaction were statistically higher in-person.Conclusion: Tele-eye care appears to be statistically and clinically non-inferior to in-person eye exams, especially for refraction, but the low prevalence of ocular pathologies somewhat limits the comparison of its efficacy for ocular health assessment. More studies on comprehensive tele-eye care exams are needed.Keywords: primary eye care, tele-eye care, tele-ophthalmology, tele-optometry, tele-refraction
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