Vision from Afar


	At the Carl Albert medical facility in Ada, Oklahoma, Richard Jones sits still in a face restraint while his retina is photographed. (Photograph by John Gapps III)

magine spending the rest of your life in total darkness, knowing that if you lived only 82 miles northwest you might still have your eyesight. This sad fate was common among Oklahoma's Chickasaw Indians until some inventive doctors enlisted the Internet to help alter these Native Americans' destinies.

"Diabetic retinopathy is the leading cause of blindness among working-age Americans, and among the Chickasaw who live in Ada, Oklahoma, this eye disease is even more pronounced," says Dr. Stephen Fransen, assistant professor of Ophthalmology at the University of Oklahoma's Dean A. McGee Eye Institute in Oklahoma City. The condition is treatable if caught early, but for many Chickasaw, it's often discovered too late because Institute doctors capable of diagnosing the disease are 82 miles away. Until June 1995, fewer than half of these diabetics were getting the annual eye screening they so desperately needed.


	The retina is photographed by a digital still camera modified to fit a device operated by Dr. John Garber, who is checking Jones for diabetic retinopathy, a condition of the retina that causes blindness in Native Americans at a rate five times that of the rest of the American population. (Photograph by John Gapps III)


	Dr. Steve Fransen (front) and Dr. Lloyd Hildebrand review the image of Jones' retina. Fransen wears a pair of infrared-controlled 3D glasses to review the scan, which was acquired earlier that day at the Carl Albert medical facility, 82 miles away. (Photograph by John Gapps III)

That all changed when ophthalmologists at McGee began using a system to screen for diabetic retinopathy from a distance. Now patients no longer need to travel for specialized tests; instead, doctors located in Ada transmit images of the patients' retinas over the Internet to the Institute. Results are returned immediately via the Internet while the patient is still in the doctor's office.

"We're finding that when patients are informed right away of their screening results, most of them comply with treatment recommendations," Fransen says. The Internet has made the difference in assuring the prompt treatment crucial to saving the eyesight of people with high-risk diabetes.

Fransen has high hopes for this project. "Soon we'll be using this system to manage the eye care for all 7,000 diabetics among the Chickasaw population in Oklahoma."

http://www.niddk.nih.gov/DiabeticEyeDisease.htm