PURPOSE: To report the accuracy of telemedical slit-lamp evaluation in examination of ocular adnexa and anterior segment. METHODS: By means of contingency tables, slit-lamp findings by live examination and by real-time telemedicine were compared in 50 eyes of 25 patients. RESULTS: Sensitivity percentages (proportion with findings correctly identified by telemedicine)/specificity percentages (proportion without the finding that was correctly identified by telemedicine) were 100/64 for eyelid mass, 100/85 for conjunctival pigment, 100/100 for posterior synechiae, 80/0 for blepharitis, 83/93 for iridotomy, 70/93 for pinguecula, 75/93 for iris lesions, 56/98 for corneal scar, 0/100 for chamber inflammation, 57/93 fur nuclear cataract, and 37/100 for intraocular lens presence. CONCLUSIONS: By means of monocular slit-lamp telemedical evaluation, clinical findings with high contrast cues for color and depth have the highest sensitivity and specificity. (Am J Ophthalmol 1999;127:464-466. (C) 1999 by Elsevier Science Tnc, All rights reserved.).