VR devices practical for visual field testing in resource-limited settings
Virtual reality visual field testing can provide a practical and convenient means of screening for and monitoring glaucoma in settings where standard automated perimetry is limited or unavailable.
“Visual field testing is often not performed in resource-poor settings due to lack of access to standard automated perimetry (SAP),” Celestine Gregerson, from the University of Utah School of Medicine, said during her ARVO presentation. “In addition, they have a large physical and electrical footprint. This makes their use both inconvenient and limited in rural settings around the world.”
With the recent advancements in virtual reality (VR) technology that are “lightweight, comparatively inexpensive and convenient to use,” Gregerson and colleagues sought to explore VR devices as a practical alternative in outreach field settings.
The study comprised 56 adults from ophthalmology clinics in Utah and Tanzania, including 33 patients with a known history, suspicion of or risk factors for glaucoma. A technician conducted visual field testing using a head-mounted VR device with the C3 Fields Analyzer (Alfaleus) smartphone software. Patients and technicians then answered an anonymous questionnaire with scores of 0 to 5.
One average, patients reported high scores for device comfort (4.33), understanding test instructions (4.53), ability to remain alert during the test (4.62) and willingness to retake the test (4.62).
Technicians reported similarly high scores for ease of device setup (4.87), software usability (4.89), device portability (4.91), patient comfort (4.79) and impression of patient understanding (4.69).
Physicians felt the test was reliable 79% of the time, that a true visual field defect was seen 34% of the time, and that results helped make a diagnosis or management decision in 70% of cases.
“Our goal here was not to compare SAP devices to VR devices, rather we were primarily interested in evaluating the utility of virtual reality in areas where there would be highly limited access to SAP and the alternative would be no visual field testing,” Gregerson said. “Outreach settings would benefit from continued improvements in VR visual field testing devices and software.”
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Gregerson C, et al. Usability of a portable virtual reality device for visual field screening in outreach settings. Presented at: Association for Research in Vision and Ophthalmology meeting; May 6, 2020 (virtual meeting).
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