In prisons, prison medical officers provide general medical care. However,
if specialist care is needed then the prisoner is transported to a speciali
st medical centre. This is a costly procedure and prison escapes occur duri
ng transportation. We have tested our Internet-based eye care system in pri
sons in Western Australia. Medical and ophthalmic history, visual acuity an
d intraocular pressure were stored in a browser-based multimedia database.
Digital images of the retina and the external eye were recorded and transmi
tted to a central server. Based on the medical data and the digital images,
the specialist ophthalmologist could provide a diagnosis within 24 h. Elev
en patients (mean age 48, range 30-82 years) were reviewed during two separ
ate visits to a maximum-security prison in Western Australia. Our main aim
was to train prison medical officers and nurses to operate the portable oph
thalmic imaging instruments and to use the Internet-based eye care system.
The outcome of the pilot study indicated that considerable savings could be
made in transport costs and the security risk could be reduced. The Minist
ry of justice in Western Australia has decided to implement telemedicine se
rvices to provide regular ophthalmic consultation to its prisons.