Fig. 1.

The interplay of synchronous and asynchronous telehealth with incorporation of artificial intelligence. Synchronous telehealth is live/interactive telehealth that can be either clinic or home based. It includes video or phone visits. Asynchronous telehealth is a “store-and-forward” approach where testing/information is obtained and then shared through a portal for a physician to review later. Hybrid telehealth incorporates both synchronous and asynchronous modalities including capturing a visual field or fundus photograph asynchronously for the neuro-ophthalmologist to review at a later time point. A video visit is then scheduled for the neuro-ophthalmologist to synchronously review with the patient the testing results and care management plan. An example of a potential artificial intelligence (AI)-driven future state of neuro-ophthalmology is where asynchronous data is obtained via augmented reality (AR) home monitoring of a visual field defect. Deep learning (DL) algorithms then interpret the change in the visual field defect from previously obtained visual fields of the patient. If there are significant changes, DL can then pivot to either alert scheduling of an urgent synchronous video visit or a routine video visit with the patient