Eyelid Lesion Telehealth Can Detect Malignancies, Minimize Wait Times

An eyelid lesion telehealth clinic can reliably identify eyelid malignancies and reduce wait times between referral to assessment and referral to treatment among patients with eyelid lesions, according to a study published in Eye.

The study authors highlight the importance of this finding. “Uptake of tele-medicine has long been a feature in ophthalmic clinical practice; however, the COVID-19 pandemic provided a catalyst to the rapid expansion of virtual services both in ophthalmology and the wider medical world,” they explain.

Researchers retrospectively reviewed data from 808 patients who underwent clinical eyelid photography at a single eyelid lesion telehealth center between September 2020 and September 2021. Trained medical photographers completed symptom questionnaires, which included patient symptoms and historical information pertaining to the lesion. Photographs and questionnaires were shared with an oculoplastic surgeon, who either discharged the patient with care advice, booked a clinical visit, or scheduled a surgical procedure.

Chalazion was the most common diagnosis recorded (38.4%) by the eyelid lesion telehealth center, the report shows. Mean referral to appointment time decreased significantly between the first 4 months and last 4 months of the service (93 days to 22 days, p ≤ .0001). 

The eyelid lesion telehealth initiative identified patients who did not require further in-person treatment, and 266 (33%) patients were discharged following photographs — 371 patients (46%), however, underwent scheduling for a minor procedure. The photography clinic identified 13 biopsy-confirmed malignant lesions and 7% of patients among 330 with 6 months follow up were re-referred. No periocular malignancies were missed in any of these patients, according to the report.

“[W]e demonstrate that an image-based asynchronous teleconsultation model for the assessment of patients with presumed benign eyelid lesions is efficient and safe,” according to the investigators. “It Is able to reduce waiting times for an assessment appointment, allow clinicians to work flexibly and minimize use of clinic consultation space while accurately identifying periocular malignancies requiring prompt treatment.”

Study limitations include its retrospective nature, a lack of follow-up data, incomplete recordings, failure to evaluate patient satisfaction, and the eyelid lesion telehealth clinic’s inability to confirm a diagnosis.