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Military to bring eye care to front lines with 59th MDW-funded mobile app

By Shireen Bedi | Air Force Surgeon General Public Affairs | April 8, 2019

FALLS CHURCH, Virginia —

Eye injuries in a deployed setting can be a significant setback for any Airman, but new telemedicine capabilities are helping to keep them in the fight. 

With funding from the 59th Medical Wing, Joint Base San Antonio-Lackland, Air Force and Army medical researchers are developing a HIPAA-compliant smart phone application to connect providers downrange with on-call ophthalmologists either in-theater or at a clinic.

“Ten to 15 percent of combat injuries involve the eye,” said Maj. (Dr.) William G. Gensheimer, ophthalmology element leader, and chief of cornea and refractive surgery at the Warfighter Eye Center, Joint Base Andrews, Maryland. “There may not be many ophthalmologists in a deployed setting.”

The smart phone application, called FOXTROT, which stands for forward operating base expert telemedicine resource utilizing mobile application for trauma, will bring specialty eye care much closer to the point of injury. Specifically, it will allow providers downrange to conduct eye exams and assist with diagnosis and the management of eye injuries.

“If there is Wi-Fi connectivity, the user can video teleconference an ophthalmologist either in theater, in a clinic in Germany or back in the United States and receive real-time consultation for their patient,” Gensheimer said. “When there is no connectivity, the application will function like secure email and the medic can send the necessary information.”

According to Army Lt. Col. (Dr.) Jennifer Stowe, an optometrist and deputy director of administration at the Virtual Medical Center, JBSA-Fort Sam Houston, FOXTROT addresses the need for specialized telemedicine capabilities that specifically focuses on treating eye trauma downrange.

“As it stands, the current technology does not have the technical requirements necessary for deployed eye care,” Stowe said. “As an optometrist, it is without a doubt an expected capability to speed up recovery in a deployed setting.”

As Gensheimer explains, having this type of technology downrange could ensure the readiness of service members, improving the chances they can return to duty much sooner.

“With the application a downrange provider can consult an ophthalmologist and the service member can receive treatment much sooner than before,” Gensheimer said. “This improves the chances of preserving their eyesight and potentially return them to duty much more quickly.”

In addition to improved care downrange, Stowe says that the application could have a positive impact on the readiness of military medical providers. Increased exposure to a wider variety of patients through the application gives them a deeper and broader experience of practice.

“The more complex patients we see, the more our case mix increases, and the more talented as providers we become,” Stowe said. “This application will increase our medical readiness as providers by increasing our knowledge base in how we care for eye trauma.”

Currently, the application is being developed in collaboration with the U.S. Army Medical Research and Materiel Command’s Telemedicine and Advanced Technology Research Center.

The next steps are to test the application to ensure it functions well downrange and develop standardized protocols for the use of the application.

“We want to make sure that the application can transmit the necessary information and assist ophthalmologists in making correct diagnoses and developing treatment plans,” Gensheimer said. “Having access to this type of care can have a significant impact on readiness, reducing eye injury evacuations and improving health outcomes.”