Although virtual reality perimetry isn’t a new concept, the device to administer it had not been perfected. Alberto Gonzalez-Garcia, MD, president and CEO of Olleyes, Inc., saw the gap as an opportunity and created its VisuALL virtual reality (VR) platform, which leverages VR technology to deliver a mobile visual field test.

Davinder Grover, MD, MPH, a glaucoma specialist at Glaucoma Associates of Texas, who started using the device in the spring of 2020 when the COVID-19 pandemic worsened, says, “Our traditional Humphrey visual field machine was time consuming to clean and slowed patient flow. The VR headset improved clinical efficiency while providing the same quality of care in a safer way. I am extremely satisfied with the headset, and patients have had positive feedback about their experiences.”

Patients using the VR headset can sit in any position they find comfortable — including lying down, which is ideal for patients in hospital beds. Patients can move their head during testing. Room lighting can remain on. The device tests both eyes simultaneously; extra time isn’t needed to switch between eyes during testing, patients don’t have to wear an eye patch over one eye, and the risk of fatigue is lower. Practices can use more than one VisuALL simultaneously. The headset weighs less than 7 ounces, fits over the patient’s head like any VR headset, and can be worn comfortably over glasses, so additional corrections aren’t needed. It is easy to sterilize by wiping it down.

“Greater comfort increases the test’s quality,” Dr. Gonzalez-Garcia says.

Algorithms on VisuALL that offer a video-game interface make it more interesting for children and help increase their attention during the test. Also, VisuALL offers multiple tests on a singular VR headset, including visual field, visual acuity, and color vision. Other functions continue to be added, which will increase the device’s efficiency and cost-effectiveness. Furthermore, “The headset is a fraction of the cost of traditional machines,” Dr. Grover adds.

A report¹ showed that for normal and mild glaucoma cases, VisuALL performed as well as the Humphrey visual field test. “For some patients it worked even better, and picked up slight visual field defects that are classic for glaucoma sooner than the traditional method,” Dr. Grover says.

Dr. Grover uses the headset for all types of glaucoma patients, as well as individuals with ocular hypertension and those who are glaucoma suspects. “I currently find it more useful for patients with healthy and mild eye conditions because there are insufficient data, but we’re collecting additional data to increase validation on more advanced cases,” he says.

The pandemic will leave an impression on society for years. “Patients will still be reluctant to visit doctors’ offices and they’ll be more amenable to home monitoring and telemedicine,” Dr. Grover says. Repeat tests are also easier with a home-monitoring device, he adds. “Testing once a week or month provides better data on structural functionality.” GP

Reference

1. Razeghinejad R, Gonzalez-Garcia A, Myers JS, Katz LJ. Preliminary report on a novel virtual reality perimeter compared with standard automated perimetry. J Glaucoma. 2021;30(1):17-23. doi:10.1097/IJG.0000000000001670.