Ocular telemedicine can deliver eye care to millions of Americans who do not have access to services. This K23 proposal demonstrates Dr. Maria A. Woodward's commitment to research that addresses a national and global public health care need and her commitment to the pursuit of investigator independence. Although posterior eye diseases cause the majority of visual impairment in the United States, the National Eye Institute's (NEI) strategic plan states that anterior eye diseases result in the majority of visitsto eye care professionals nationally and cause blindness in millions globally. The NEI plan also emphasizes the significant need for research that can """"""""establish the safety, reliability and feasibility of telemedicine procedures through pilot studies"""""""" and """"""""determine which ophthalmic applications are amenable to telemedicine, while still preserving the accuracy, sensitivity and specificity achieved with in-person examinations."""""""" Although funded research projects have established fundus photography for remote assessment of diabetic retinopathy, no pilot projects have focused on the external and anterior eye. Dr. Woodward's career public health goal is to extend affordable and accessible eye care to underserved communities in order to detect eye conditions earlier in their course. Her career research goal is to test applications of ophthalmic technology that are amenable to telemedicine. The immediate project goals are two-fold. First, the applicant seeks to develop rigorous and accurate methods for detecting key external and anterior eye diseases using external photography. The applicant will conduct pilot studies testing external photography protocols on subjects with known anterior eye diseases. Second, the applicant seeks to validate a vision questionnaire that will augment comprehensive telemedicine assessments to determine eye health and whether or not anterior eye diseases are present. The applicant will administer multiple pre-validated vision questionnaires (e.g., the National Eye Institute Visual Function Questionnaire) and correlate answers with clinical examination findings. Dr. Woodward's research is supported by training goals that will provide the foundation for her to develop into an independent investigator. The applicant will utilize the immense resources at the University of Michigan and the support of research mentors, including Drs. Paul Lee and David Musch, to accomplish three specific training aims: 1) expertise in research methodology, 2) excellence in telemedicine programmatic development, and 3) refined knowledge of ophthalmic imaging. Dr. Woodward has set forth a plan for targeted coursework, individualized mentorship, and directed self-study to assure achieving these aims. In the process, she will obtain a master's degree in health and health care research from the Robert Wood Johnson Foundation Clinical Scholars Program.

Public Health Relevance

This project aims to provide new clinical guideposts for remote eye care - a promising solution to the challenge of providing care for the millions of Americans with inadequate access to services. The research evaluates two new key components for comprehensive telemedicine eye disease assessment: (1) protocols for external photography for anterior eye diseases and (2) a comprehensive vision questionnaire. The goal is to grow ocular telemedicine programs across the country to help patients and doctors in underserved communities.

National Institute of Health (NIH)
National Eye Institute (NEI)
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
Application #
Study Section
Special Emphasis Panel (ZEY1)
Program Officer
Agarwal, Neeraj
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Michigan Ann Arbor
Schools of Medicine
Ann Arbor
United States
Zip Code
Todorich, Bozho; Thanos, Aristomenis; Yonekawa, Yoshihiro et al. (2017) Simultaneous dexamethasone intravitreal implant and anti-VEGF therapy for neovascular age-related macular degeneration resistant to anti-VEGF monotherapy. J Vitreoretin Dis 1:65-74
Shah, Ankoor R; Yonekawa, Yoshihiro; Todorich, Bozho et al. (2017) Prediction of Anti-VEGF Response in Diabetic Macular Edema After 1 Injection. J Vitreoretin Dis 1:169-174
Patel, Tapan P; Prajna, N Venkatesh; Farsiu, Sina et al. (2017) Novel Image-Based Analysis for Reduction of Clinician-Dependent Variability in Measurement of the Corneal Ulcer Size. Cornea :
Valikodath, Nita G; Newman-Casey, Paula Anne; Lee, Paul P et al. (2017) Agreement of Ocular Symptom Reporting Between Patient-Reported Outcomes and Medical Records. JAMA Ophthalmol 135:225-231
Jeganathan, V Swetha E; Robin, Alan L; Woodward, Maria A (2017) Refractive error in underserved adults: causes and potential solutions. Curr Opin Ophthalmol 28:299-304
Miller, Sarah E; Thapa, Suman; Robin, Alan L et al. (2017) Glaucoma Screening in Nepal: Cup-to-Disc Estimate With Standard Mydriatic Fundus Camera Compared to Portable Nonmydriatic Camera. Am J Ophthalmol 182:99-106
Woodward, Maria A; Bavinger, J Clay; Amin, Sejal et al. (2017) Telemedicine for ophthalmic consultation services: use of a portable device and layering information for graders. J Telemed Telecare 23:365-370
Stem, Maxwell S; Todorich, Bozho; Woodward, Maria A et al. (2017) Scleral-Fixated Intraocular Lenses: Past and Present. J Vitreoretin Dis 1:144-152
Thomas, Benjamin J; Mehta, Neesurg; Yonekawa, Yoshihiro et al. (2017) PARS PLANA VITRECTOMY FOR LATE VITREORETINAL SEQUELAE OF INFECTIOUS ENDOPHTHALMITIS: Surgical Management and Outcomes. Retina 37:651-656
Stagg, Brian C; Shah, Muazzum M; Talwar, Nidhi et al. (2017) Factors Affecting Visits to the Emergency Department for Urgent and Nonurgent Ocular Conditions. Ophthalmology 124:720-729

Showing the most recent 10 out of 29 publications