Abstract
Objectives: The purpose of the current research is to examine and analyze the attitudes of healthcare service users towards the integration of remote medical services into ophthalmology in Bulgaria, including teleglaucoma. Methods: A cross-sectional survey study was conducted among 902 healthcare users during the period from May 2023 until December 2024. Descriptive statistics, parametric, and non-parametric tests for hypothesis testing were used. Results: The present study outlined predominantly positive attitudes towards the use of telemedicine services in ophthalmology, with 69.6% of respondents reporting a positive overall opinion in the final assessment. The greatest support was observed during remote consultations with a familiar doctor (77.4%) and during continuous follow-up of eye conditions (55.2%). Willingness to use such services was lower in emergencies or when contacting an unfamiliar specialist. A significant correlation was established between socio-demographic characteristics and attitudes-respondents with greater education levels (p = 0.006), men, and younger participants were more positive towards telemedicine (p < 0.05). The high level of awareness about glaucoma, particularly among those with university-level education, served as a positive prerequisite for the implementation of teleophthalmology services related to its monitoring. Mobile applications and digital solutions were evaluated as beneficial means of facilitating communication and increasing adherence to treatment. Regarding the use of artificial intelligence, certain skepticism and insufficient awareness levels were observed, which required additional efforts to increase trust and digital literacy among users. Conclusions: The implementation of telemedicine services into ophthalmology has potential but outlines the necessity of considering the individual attitudes of applying coherent quality and safety standards and of directed awareness campaigns, especially towards the groups of lower technological and healthcare literacy.