Table 2.

Teleophthalmology Versus Traditional In-Person Dilated Eye Exam for Diabetic Eye Screening

Themes	Example quotes
Teleophthalmology is better at detecting eye disease than an in-person eye exam	“[Teleophthalmology] is advanced technology and can point out things that the old test can't or find things that the old test can't or is more accurate.” (Patient 6) “It seems to me that electronic equipment works better than manual things like [a traditional dilated eye exam].” (Patient 10) “I suppose [teleophthalmology is] more precise because science is advancing, not the other way ‘round [laughs]… I think I'd rather have the most advanced [screening method] because it can help me more.” (Patient 14)
Teleophthalmology allows the patient to see their screening results with the eye photo	[The patient] can see what [their] eye looks like—what's there, which you can't see with the [traditional eye exam].” (Patient 1) “With the photo, we can compare this photo… to another photo next year or in two years, in three years. And I don't have to rely on my memory or my notes to see if there's a difference.” (Patient 18)
Teleophthalmology doesn't require dilating eye drops	“[For teleophthalmology…] you don't need drops… and to find someone who can drive… when it's over.” (Patient 15)
Teleophthalmology is more affordable, convenient, and time efficient	“$20 [for an eye photo] isn't that bad either, though. It's really not. That's very, very cheap, because I'm assuming this [camera that takes the eye photo] is probably thousands of dollars.” (Patient 5) “[I prefer teleophthalmology] because it's more efficient… I've been sent to [a different clinic] for [eye] tests, so, it would be nice if [the primary care clinic] had their [own] eye clinic as well.” (Patient 1) “If [my primary care clinic] gave me a yearly eye exam, I'd be happy because it would give me peace of mind knowing that I can see my progress every year.” (Patient 2)
Teleophthalmology complements the in-person physical exam by the PCPa	“After [the PCP] examines you, they can see in the picture if there is or isn't any damage… [in case the PCP] couldn't see it, huh? So, I think one complements the other, but the [PCP's] examination is very important.” (Patient 7)
Distrust of technology	“I feel like [people would prefer] the standard one… Many people don't really trust technology that much.” (Patient 8)
Preference for following a doctor's recommendation regarding method of diabetic eye screening	“I trust the doctors and whichever [method of eye screening] that they say that I should do, that's the one I'm going to do. Because they're the ones who are going to read the results, and what they think is going to be best.” (Patient 2) “[It's] not for me to decide [which exam to get]. That's for the doctor to decide… and I'd agree.” (Patient 10) “You have to follow everything [the doctor] says… You can't say ‘No, the drops make my eyes hurt’… The doctor knows what they're doing. They're specialists.” (Patient 12) “I wouldn't know how to answer [which type of screening I would prefer], because… only those who do eye exams know how to check it… I trust them, because that's what they study, and they are qualified.” (Patient 19)

^a PCP, primary care clinician.