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Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London



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Remote assessment of ptosis using 2D photography and a bespoke questionnaire

Author: Victoria Barnett
ePoster Number: 277


To assess safety and effectiveness of remote assessment of ptosis and dermatochalasis using photography and a questionnaire.


Prospective study of 30 patients referred to Moorfields Eye Hospital with ptosis or dermatochalasis. Clinicians obtained a standard set of smart phone photographs and completed a bespoke questionnaire to record history of presenting complaint, and full ocular and medical history. A senior clinician reviewed photographs and questionnaire findings to devise diagnosis and management which were compared to those of face-to-face (F2F) clinicians.


48 patients were referred with ptosis or dermatochalasis aged from 16-88 years. 30 patients with complete data were included. F2F diagnosis included 16 ptosis, 8 dermatochalasis with or without ptosis, 1 facial and lid oedema, 4 needed myasthenia gravis or thyroid serology, 2 needed imaging and 1 had dry eyes. F2F and remote diagnosis agreed in 28/30 (93%). In 1 case, F2F clinician concluded the symptoms were due to dry eyes rather than dermatochalasis. In 1 case, remote reviewer did not detect brow ptosis. Management agreed in 25/30 (83%). In all 5 cases, F2F clinician decided to treat ocular surface disease prior to considering surgery, while remote reviewer offered surgery. Remote clinician was certain of the diagnosis in 90% (27).


Patients referred for ptosis can experience delay in diagnosis and management and lengthy total time spent in hospital for investigations and appointments, putting unnecessary strain on outpatient services and increasing risk of Covid transmission. 2D photos alongside our focused questionnaire can be used to triage patients into appropriate services and to arrange investigations before consultation. Limitations of 2D photos include inadequate assessment of ocular surface, ocular motility, pupils, dynamic eyelid movements and subtarsal conjunctiva. Our results demonstrate reasonable agreement between F2F and remote review and support the development of streamlined outpatient services where referrals are triaged by remote assessments to improve efficiency and patient experience.

Additional Authors

First nameLast nameBase Hospital / Institution
KarenWongMoorfields Eye Hospital
IngaNeumannMoorfields Eye Hospital
SwanKangMoorfields Eye Hospital

Abstract ID: 21-184