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Second Opinion on Ophthalmology
Remote consultations in ophthalmology are carried out in order to obtain a second opinion on the established or presumptive diagnosis of eye diseases, to interpret the available results of diagnostic instrument tests, clinical, laboratory, ultrasound and radiological examinations, to obtain recommendations for treatment or further diagnostic tactics. The main range of problems for which this form of medical consultation is advisable and technically feasible covers the following eye diseases: vision changes in need of correction (hyperopia, myopia, presbyopia), cataracts, optic nerve lesions, glaucoma, (age-related) macular dystrophy, degenerative changes in the cornea, diseases of the retina, iris, vitreous body, eye tumors (basal cell carcinoma, carcinoma, melanoma), inflammatory eye diseases, traumatic eye lesions. Remote second opinion could have a high degree reliability by the provision of the following examination results: tonometry, perimetry, slit lamp examinations, refraction measurements, optical coherence tomography and fluorescence angiography. Remote second opinion in the pediatric ophthalmology allows to confirm strabismus, to obtain medical recommendations for further treatment, its scope, optimal timing and stages.
An ophthalmologist, involved in giving a second opinion, makes a conclusion about his agreement with the previous diagnosis, or questions its correctness on the basis of incomplete examination or different interpretation of its results. In the latter case are to be given the proposals for further diagnostic measures. An important aspect of the remote second opinion procedure is the assessment of therapeutic options and suggestions for the further treatment and observation tactics. The consulting doctor gives an opinion on the conservative or surgical treatment advisability. He can also, by the presence of a complete diagnostic picture and according to his conclusion, recommend the most suitable, in this particular case, drug regimen.
The possibilities of getting a second opinion may be limited by ophthalmic patients with concomitant diseases. This may be due to the presence of other, as a rule, systemic diseases, including diabetes, rheumatological, neurological, vascular, and genetic diseases. In these cases, the diagnosis can be confirmed or excluded interdisciplinary, with the involvement of specialized consultants: internists, endocrinologists, rheumatologists, neuropathologists, vascular specialists or geneticists. In principle, they can be initially involved in the remote consulting process together with ophthalmologists. An extramural Concilium is also possible, when a general treatment concept is to be developed by two or more specialists working in the same clinic. In this case, additionally involved specialists are provided with examination results corresponding to their profile.
Specialists in Ophthalmology
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