Eye Exam in the Virtual World: A Pilot Study - Eye Exam in the Virtual World: A Pilot Study - Open Access Pub

This study investigated the feasibility of using three-dimensional (3D) technology as a multi-functional visual stimulus to assist the clinical eye exam. Specifically, we examined: (1) whether the receding movement of a 3D fixation target into distance could relax the accommodation of non-cycloplegic hyperopic subjects so that accurate refraction measurements could be achieved; (2) the feasibility of using the left-eye and right-eye images from the 3D monitor as the light source to perform swinging-flashlight pupil tests; and (3) the implementation of 3D technology to interrupt the binocular visual/motor fusion as required for the clinical cover test to identify strabismus. Using a 3D TV to provide visual stimuli and a photoscreening (PS) device, near-infrared (NIR) eye images were acquired and analyzed for each of the three objectives. The result of accommodation test showed that with visual stimuli, the maximal hyperopic refractions could more accurately suggest the patients’ true refractions and the more hyperopic patients responded more to the 3D projected distance. However the very mild hyperopia did not show significant response. The pilot tests also showed distinguishable normal and abnormal pupillary responses with 3D image illumination and also the difference in phoria and tropia in the ocular alignment test using 3D stimuli. DOI10.14302/issn.2470-0436.jos-17-1479 In recent years virtual reality (VR), augmented reality (AR), and various types of 3D-imaging technology have blossomed. Stereoscopic technology provides more realistic perception to viewers. In medical practices, it allows more accurate analyses of the morphology, and therefore, helps to improve surgical accuracy, reduce operation times, and enhance patient safety 1, 2. 3D technology can also be applied in an altered way, for the vision assessment. Stereoscopic viewing requires both eyes to work in coordination as they converge, focus, and track the target. Deficiencies of such coordination reveal difference between two eyes and undiagnosed problems 3. As indicated in the “3D in the classroom” document from American Optometry Association, “the ability to perceive depth in a 3D presentation is an effective vision health indicator that has much higher sensitivity than the standard eye chart that has been used for the last 150 years” 4. Children with ocular diseases are often unaware of their impairment until a later stage when treatment is less effective. The importance of regular vision screening is indisputable, but comprehensive examinations for all children would put a significant