Assessing visual performance in real-world situations is difficult to do in a clinical setting. A recent study in JAMA Ophthalmology, explored the use of virtual reality (VR) in identifying vision-related disability in patients with glaucoma.
In this cross-sectional study, patients with glaucoma (n = 98) and healthy individuals (n = 50) were recruited from a single eye clinic between August 30, 2016 and July 31, 2017.
Patients underwent VR simulations of supermarket shopping, stair and city navigations in daytime, and stair and city navigations in nighttime.
Approximately 62% of patients with glaucoma had moderate or advanced visual field (VF) defects. The time required to complete the VR simulations by patients with glaucoma versus healthy individuals was longer by 15.2 seconds (95% CI, 5.5-24.9 seconds) or 34.1% (95% CI, 12.4%-55.7%) for the shopping simulation, 72.8 seconds (95% CI, 23.0-122.6 seconds) or 33.8% (95% CI, 10.7%-56.9%) for the nighttime stair navigation, and 38.1 seconds (95% CI, 10.9-65.2 seconds) or 30.8% (95% CI, 8.8%-52.8%) for the nighttime city navigation.
There was not a significant difference in duration between the groups in the daytime stair and city navigation simulations. The risk of accident increased by 15% in nighttime stair (hazard ratio [HR], 1.15; 95% CI, 1.08-1.22) and city (HR, 1.15; 95% CI, 1.08-1.23) navigations for each decibel decrease in binocular VF sensitivity.
Approximately 59% of patients with glaucoma had vision-related disability in at least 1 simulated daily task. Nighttime city and stair navigation had a higher proportion of vision-related disability than in daytime.
The authors concluded that lighting condition and task is associated with vision-related disability in patients with glaucoma.
“Virtual reality may allow eye care professionals to understand the patients’ perspectives on how visual impairment imparts disability in daily living and provide a new paradigm to augment the assessment of vision-related disability,” the authors wrote.
Lam AKN, To E, Robert N. Weinreb RN, et al. Use of virtual reality simulation to identify vision-related disability in patients with glaucoma. JAMA Ophthalmol. 2020. doi:10.1001/jamaophthalmol.2020.0392