Teleophthalmology and Vision 2020 in South Africa.

We aimed to determine whether teleophthalmology has a place in the South African health care delivery system and its role in Vision 2020 in South Africa. We used a consensus process to determine its impact on the diagnosis and management of patients seen in a hospital eye clinic. Edendale Hospital, Pietermaritzburg, and Moorfields Eye Hospital, London, collaborated in this study involving 90 patients seen between May 2000 and April 2001. Teleophthalmology had an impact on diagnosis in 46% of cases, on management in 78%, on outcome in 63% and on medical education in 11% of cases. The South African government has identified telemedicine as a strategic tool to facilitate delivery of equitable health care services to all South Africans, irrespective of distance and availability of specialised expertise, particularly in rural areas. Teleophthalmology has been identified as one of the key applications of this initiative. The International Agency for the Prevention of Blindness, in partnership with the World Health Organisation Prevention of Blindness Programme, launched the Vision 2020 initiative in 1999, with the aim of eliminating avoidable blindness in the world by the year 2020. Cataract and refractive error have been identified as priority diseases to be tackled in the first phase of this programme, and glaucoma and diabetic retinopathy as priorities in the second phase.