Teleophthalmology Prevents Unnecessary Evacuation from Warzone.

The purpose of this case report is to highlight the benefits of using teleconsultation to diagnose ophthalmologic conditions within the restraints of a combat environment. A previously healthy 49-year-old service member deployed in the Middle East presented with diplopia over the course of 2 weeks. Initial diagnosis by his primary care physician upon partial ophthalmologic exam was a pupil-sparing CN III palsy without ptosis. Initial teleconsultation response from Naval Medical Center Portsmouth was within 6 hours. After an ophthalmologic sensorimotor examination was videotaped and sent to the referred ophthalmologist, teleconsultation was completed and discussed with the patient. The updated diagnosis was CN IV palsy with slight right hypertropia worse on left gaze-most likely congenital in origin. Upon further follow-up stateside, his final diagnosis was diplopia related to thyroid disease. Overall, his diagnosis remained a nonurgent condition that allowed the service member to remain at his duty station and prevent an unnecessary evacuation. Ultimately, teleconsultation provided many benefits for the service member and the U.S. military.