Only one or two ophthalmologists see patients in a central hospital in rural areas, such as the Dohoku area in Hokkaido. This situation is different for other doctors, such as internists, because there are usually several of them and they can discuss cases with several doctors of the same specialty in the same hospital or the same area. Therefore, the university hospital support system is important beyond the local network. With a tele-ophthalmology system is established, the ability to communicate with other ophthalmologists when a rural ophthalmologist cannot establish a diagnosis or decide to refer a patient to the university hospital would not only reduce the patient’s time and economic burdens and solve the medical disparity but also would reduce the ophthalmologist’s stress level. Furthermore, the ability to communicate with other ophthalmologists should result in earlier discharge from the university hospital or earlier referral to a rural hospital. Because ophthalmologists are required to use numerous examination instruments that require special skills, a doctor of another specialty cannot replace an ophthalmologist. We hope that improvements in the tele-ophthalmology system solve this problem, and a national government-approved tele-ophthalmology system comes to fruition. The tele-ophthalmology system requires not only a numeric data and a TV-conference system but also high quality images and videos; therefore, a tele-ophthalmology system would be able to be integrated into other telemedicine systems.
