VA brings vision-saving eye screening closer to home for Veterans

Robert, a Veteran from a rural town in Iowa, recently visited the Mason City VA Clinic to establish his VA care. As part of the process, he was sent to the Technology-based Eye Care Services (TECS) room for an eye screening.

Around the same time and several states away, another Veteran named Donald traveled a short distance to the Atlanta VA Clinic for a TECS appointment to get prescription eyeglasses.

Thanks to these TECS visits, both Robert and Donald were saved from losing their vision.

Early detection can save eyesight

Routine eye exams are an important part of maintaining your overall health, especially as you age and the risk for vision problems increases. Many eye diseases that can lead to vision loss show no symptoms in their early stages. Only an eye care specialist can identify them.

Rural communities are currently facing a shortage of eye specialists. That’s where TECS comes in.

What is TECS?

TECS is part of VA’s national TeleEye program and was established as a VA Office of Rural Health enterprise-wide initiative in 2017. Rather than traveling a long distance to their closest VA Medical Center to visit an eye care specialist, a Veteran can go to their local VA primary care clinic for a TECS visit.

“Telehealth really allows us to expand our access to be closer to Veterans, so they save time and travel costs,” said Dr. April Maa, TECS founder and national TeleEye co-lead for the VA Office of Connected Care.

During a TECS visit, a qualified ophthalmology technician who is certified at the assistant level or higher conducts a routine eye exam to check the Veteran’s vision. They screen for common eye diseases, such as cataracts, diabetic retinopathy, glaucoma and macular degeneration.

The technician collects information using digital retinal cameras, tonometers for checking eye pressure and other ocular testing devices. The clinical information is then sent to a TECS reader, a remote eye specialist who reviews the images and decides next steps for the Veteran. The TECS reader follows up with the Veteran to discuss the findings, either by phone or through VA Video Connect, VA’s secure video conferencing telehealth app.

High eye pressure detected at the Mason City VA Clinic

During Robert’s TECS appointment, Amber Ashland noted that his corrected vision was normal—20/20 in both eyes—but his eye pressure readings were off the charts.

“That was the highest eye pressures I had ever seen,” Ashland said. She immediately sought guidance from the TECS reader on duty, Dr. Morgan Pansegrau, a Clinical Resource Hub ophthalmologist, located about 90 miles away in Rochester, Minnesota. “She wanted me to give him medicated eye drops right away to get the pressures down.”

Over the next 2 1/2 hours, Ashland administered the recommended drops, monitored Robert’s eye pressure and took follow-up pictures for Pansegrau. The ophthalmologist later confirmed that Robert had glaucoma. He is now under the close watch of an ophthalmologist and he uses drops every night to keep his eye pressure within normal range.

“Glaucoma is a blinding disease that is silent until it reaches very late stages,” Maa said. “Because this patient was able to see one of our TECS programs, we were able to catch this high pressure, treat it in the clinic and get him plugged into care quickly before the high pressures caused more damage to his vision.”

“Narrow angles” found at the Atlanta VA Clinic

At the Atlanta VA Clinic, Donald also learned that he had glaucoma, but his was more advanced.

Shaquita Cooley identified “narrow angles” causing blockage in the drainage system of Donald’s eyes. She quickly got in touch with Dr. Trennda Rittenbach, the TECS reader stationed at the Clinical Resource Hub for guidance.

Cooley said she relayed Rittenbach’s instructions to quickly be seen by a glaucoma specialist. “I explained to the patient why he needed to have his angles checked and the urgency of not missing or delaying that appointment.”

“Ms. Cooley did a great job recognizing narrow angles on the patient,” Rittenbach said. “Unfortunately for the patient, he had severe chronic angle closure glaucoma that was never diagnosed or treated and so he needed emergency surgery. Her attention to detail and quality of care likely saved this Veteran from going completely blind.”

Don’t skip your routine eye screening. If there are no eye specialists near you, contact your local VA clinic to find out if they offer TECS appointments.

To learn more about VA TeleEye and other telehealth programs, visit the VA Telehealth website.