Characterizing Tele-optometry Users: Demographics, Refractive Error Profiles, and Visit Patterns Across a Multi-Site Private Practice

Abstract

Introduction Tele-optometry has emerged as a valuable model for delivering eye care remotely, enabling patients to receive vision assessments and consultations. While its use has expanded rapidly, especially during the COVID-19 pandemic, there remains a limited understanding of who accesses these services, the types of refractive error diagnosed remotely, and the patient visit patterns over the years. Purpose The purpose of the study is to describe the population demographics, characteristics of the refractive error conditions and visit patterns of individuals attending a multi-site private tele-optometry clinic in British Columbia (BC). While comprehensive clinical data including ocular health assessment was available, it is beyond the scope of this study. Method A retrospective descriptive analysis was conducted using de-identified patient data collected from a multi-site, private, tele-optometry clinic in British Columbia (BC), Canada, from 2021 to March 2025. The data analyzed included demographics (age, sex, occupation and geographical location), refractive error (sphere, cylinder, axis), pupillary distance, near addition, prism correction where applicable, and follow-up outcomes. Occupations of subjects were categorized based on the National Occupational Classification (NOC) codes, and the geographical distribution of individuals was analyzed by mapping postal codes to provide a visual representation of service reach. The spherical equivalent (SE) was calculated for each eye to classify refractive error into emmetropia, myopia, and hyperopia, and further subdivided into severity levels of low, moderate, and high. Astigmatism was categorized by the orientation of the cylinder axis as: with the rule (WTR), against the rule (ATR), or oblique. Descriptive statistics and frequency analysis were used to describe the characteristics of the subjects, and a paired t-test was used to compare the refractive data across methods. All analyses were conducted using Excel Version 16.98. Results A total of 6,708 patients were seen across five private clinical practice locations in BC. The mean age was 45.06 ± 17.29 years, with 53.85% female and 46.05% male patients. Most individuals were working adults, with 17.7% characterized as professionals and 14% as trade-skilled jobs. Patients were distributed across all five clinic locations based in BC, with the highest number of individuals residing within BC, followed by Alberta, and a smaller cluster in Saskatchewan, Newfoundland and Labrador, and the Yukon Territory. Myopia was the most prevalent type of refractive error at 50%, followed by emmetropia (28%) and hyperopia (21%). The difference in mean SE between the assessment of refractive error methods was small (<0.15 D), indicating high agreement. With-the-rule (WTR) astigmatism was the most prevalent type. The follow-up visits within 1-year were consistently more common than return visits occurring after 1-year. Conclusion These findings indicate that tele-optometry is being used primarily for convenient, locally accessible care among working-age adults and provides reliable refractive assessments using a synchronous clinical workflow. Broader representation and the analysis of clinical ocular health outcomes are needed in future studies to further understand the role of tele-optometry in comprehensive eye care delivery.