Virtual reality improves children’s visual function, eye position after strabismus surgery
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Key takeaways:
- The orthophoria rate at 6 months was significantly higher in the training group vs. the control group.
- The eye position regression rate was significantly lower in the training group vs. the control group.
Virtual reality technology may improve binocular visual function and maintain eye position following strabismus correction in children, according to a study published in the Indian Journal of Ophthalmology.
“The results of this experiment revealed that 6 months after surgery, the reversion rate of eye position in the training group was significantly lower than in the control group, while the correction rate was significantly higher, suggesting that postoperative [virtual reality (VR)] intervention helped to improve the eye position of children,” researchers at the Capital Institute of Pediatrics Affiliated Children's Hospital in Beijing wrote.
“The reason for this may be that VR comprises the construction of a fully digital 3D virtual environment. What users see when using this technology is a fully constructed virtual scene, which makes their senses, such as touch, hearing and vision, receive comprehensive stimulation under immersive conditions.”
To study the effect of VR technology after strabismus correction, researchers enrolled 200 children aged 4 to 16 years with concomitant exotropia or concomitant esotropia who underwent surgery between January 2019 and June 2021. Participants were randomly divided into a training group that received VR intervention within 1 week of surgery and a control group.
The intervention involved children wearing smart glasses or head-mounted display equipment with red and blue lenses to view images. Two training sessions were conducted in the hospital and were followed by twice-daily sessions (15-20 minutes each) at home for 3 months. Participants were monitored at 1, 3 and 6 months after training.
Although there were no significant differences in correction and reversion rates between groups at 1 and 3 months after surgery, the researchers reported that the orthophoria rate at 6 months was significantly higher in the training group compared with the control group. Furthermore, the eye position regression rate was significantly lower in the training group than the control group at 6 months.
Researchers also reported that more children experienced simultaneous vision and remote stereovision at 6 months in the training group vs. the control group. However, the differences in number of patients with peripheral stereopsis, macular stereopsis and stereopsis in macular fovea centralis at each follow-up visit was not statistically significant between the two groups.
“The intervention of VR technology after the correction of concomitant strabismus can effectively improve binocular visual function, maintain eye position and improve the cure rate after strabismus surgery,” researchers wrote.
Perspective
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I would like to applaud the authors of this study for seeking to validate the use of VR technology in eye care. As we all know, getting patients to buy in to home therapy is quite difficult, whether it is daily warm compresses or daily vision therapy exercises, and this is especially true if those patients are children.
In their discussion, the authors describe how the VR technology “provides for the creation of a broad imaginable space […], making it easy for [patients] to engage.” I think this shows us a path for how VR can be used in eye care: not as a gimmick but as a way to truly improve the patient’s engagement in the test, therefore increasing its reliability and function.
I found it interesting that after completing 3 months of twice-daily sessions lasting at least fifteen minutes each session, the authors found no difference in any of their variables between the two groups. However, after the training stopped and another three months passed, the training group saw improvements compared with the control group. Perhaps that just means more work is needed to determine the best length of treatment and to see whether patients regress to the mean after treatment.
I am excited to see more uses in eye care for testing and treating with VR. I think we as clinicians should embrace changes in our practice and recognize opportunities as they come along to improve the care of our patients.
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