Visual performance measures using a virtual reality headset to assess vision-related daily tasks in those with severely reduced vision.

Description

Purpose
How patients with low vision manage in the real world cannot be inferred directly from standard eye tests. Task performance-based measures have been developed but aren’t easily applied in clinical settings. This proof-of-concept study investigated whether a simulated environment within a virtual reality headset could be used to assess performance of vision-related tasks.
Methods
20 normally sighted volunteers who wore low-vision simulation lenses (Optima Low Vision Services, Totnes, UK) which substantially reduced their visual acuity (VA) to 1.0 log MAR and 18 patients (4 male, 14 female) who were either sight impaired (n=5,28%) or severely sight impaired (n=13,72%) performed a battery of 5 tests presented using an Oculus Rift DK2 head mounted display. LogMAR VA (number of letters) was also measured and NEIVFQ 25 completed at each visit. The test battery included two visual search tasks, telling the time on an analogue clock, gesture recognition and visually guided action. All tasks took place in a virtual New York style apartment environment. Participants completed two sessions at least 1 week apart and provided questionnaire feedback on their experience of the tests.
Results
For those using simulation spectacles repeatability was very poor for visually guided action to moderately good for gesture recognition (ρ = 0.65, p =0.008). Most tests showed evidence of a learning effect between sessions. For patients with visual impairment, repeatability ranged from ρ =0.947 for the gestures task to ρ = 0.302 for the visually guided motion. VA in better seeing eye was significantly associated with smallest clock diameter with which they could correctly identify the time (ρ=-0.764, p<0.001) and gesture recognition (ρ=-0.700, p<0.001). None of the tests correlated significantly with the NEIVFQ25 score. Patients were generally very positive about the tests and many reported that the search tasks and telling the time task best represented problems they experienced in their daily life.
Conclusions
While significant further refinement is required, this proof-of-concept pilot study demonstrated that virtual reality offers opportunities for assessing task related performance in a clinical setting that is acceptable to patients.

Period	30 Apr 2023
Event title	Association for Research in Vision and Ophthalmology Annual Meeting 2023
Event type	Conference
Location	New Orleans, United States, LouisianaShow on map
Degree of Recognition	International