[Killakwinn]

I understand why these statements might seem extreme. A few points here:

1) I don't believe I've stated that dilated eye exams should never be done. One of the biggest reasons remote eyecare is relatively far behind compared to other specialties (remote dermatology, for example) is the need to visualize the retina up to the ora, where a lot of pathology (e.g. retinal holes) can hide. Currently, the only ways to visualize the retina this comprehensively are a) scleral depressed dilated eye exams and b) use of wide retinal imaging (e.g. Optos.) Theoretically, "a" can be done in the home via an "on-call" ophthalmologist or optometrist and "b" can be done via an eye van (ZSFG actually has this option,) but neither of these can scale very well. So we're working on a scalable solution that will enable the collection of data on par with what can be gathered via a traditional dilated eye exam.

2) My 2 cents re: cost-saving and efficient glaucoma screening methods is that we need portable IOP measurement devices. Since we're currently limited by existing technology, my vote is for a using tonopen (portable, affordable, accurate) over non-contact tonometry (nonportable, expensive, not accurate) when it comes to rapid remote screening.

[cik]

I'm not an American, but I've had eye tests in both Canada and Israel. Just how expensive are these? In Canada they're free - covered by health care (Glaucoma). Regular eye tests in Canada cost ~$49 (clearly, Queen Street). In Israel they cost 22 NIS, about $6.

[ywei3410]

For some more comparisons, the UK has free eye-tests for certain groups (children and at-risk) [1], but it costs around £20-25 (~$28-$35 at current exchange rate).

[1] https://www.nhs.uk/nhs-services/opticians/free-nhs-eye-tests...

[2] https://www.specsavers.co.uk/help-and-faqs/how-much-is-an-ey...

[Killakwinn]

That is INCREDIBLE. When someone is paying for a full eye exam out of pocket in the US, it can cost anywhere from $69 to $150 USD.