Researchers from Hong Kong have concluded that virtual reality (VR) simulation could potentially improve glaucoma care by mimicking patients’ vision-related disability. Simulations that integrated visual and cognitive functions helped them discover that patients’ disability was associated with task and lighting conditions, as a higher proportion of patients had trouble performing the same task in a nighttime setting.
The team evaluated 98 glaucoma patients and 50 healthy controls with visual acuity, contrast sensitivity, visual field (VF) and National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25) score measurements. The researchers also designed five interactive VR environments displayed in a commercially available VR headset, simulating common activities such as: (1) supermarket shopping, (2) daytime stair navigation, (3) nighttime stair navigation, (4) daytime city navigation and (5) nighttime city navigation.
Patients with glaucoma took an average of 15.2 seconds longer to complete the shopping activity, 72.8 additional seconds for the nighttime stair navigation and 38.1 seconds more for the nighttime city navigation compared with the healthy individuals.
The team noted that the duration required to complete the simulations and the number of collisions in the navigation tasks were significantly associated with binocular VF sensitivity. In 59.1% of glaucoma patients, the researchers determined vision-related disability in at least one simulated daily task, as well as a higher proportion of patients in nighttime city (30.7%) and stair (30.0%) navigation than in daytime city (8.0%) and stair (19.8%) navigation simulations.
The study concludes that VR simulations of daily activities can provide an intuitive approach to help clinicians visualize and measure disability experienced by patients with visual impairment in the real world. “Understanding such differences would allow practitioners to devise appropriate treatment, visual aids and counseling to improve the quality of vision and quality of life in patients with glaucoma,” the authors wrote in their paper.
|Lam AKN, To E, Weinreb RN, et al. Use of virtual reality simulation to identify vision-related disability in patients with glaucoma. JAMA Ophthalmol. March 19, 2020. [Epub ahead of print].|