Virtual reality for glaucoma

Head-mounted VR goggles use light to stimulate targeted areas in the patient’s visual field.

Colin Kerr

Posted: Saturday, June 1, 2019

A wearable brain-based device called NGoggle that incorporates virtual reality could help improve glaucoma diagnosis and prevent vision loss. Duke University researchers funded by the National Eye Institute (NEI) have launched a clinical study testing the device in hopes that it could decrease the burden of glaucoma.
The device consists of head-mounted virtual reality goggles that use light to stimulate targeted areas in a patient’s visual field.
“Current methods for glaucoma screening and monitoring are relatively primitive,” said Felipe Medeiros MD, PhD, a study investigator, a co-founder of NGoggle, Inc, and a professor of ophthalmology at Duke University School of Medicine.
Standard screening tests measure pressure within the eye. Although elevated intraocular pressure is the main risk factor for glaucoma, not all cases of the disease are associated with high pressure. Screening for glaucoma based on single intraocular pressure measurements may fail to detect up to 80% of the patients with the disease, Dr Medeiros said. “That’s because many people develop optic nerve damage from glaucoma at relatively low intraocular pressure levels. In addition, pressure fluctuates widely throughout the day and on different days, making it difficult to rely on a single measurement for diagnosis and screening. Importantly, many subjects may also have high intraocular pressure and never develop damage to the optic nerve.”
Standard automated perimetry (SAP) is usually used to monitor glaucoma progression. SAP requires patients to click a button when lights are randomly shown for a brief time in their peripheral vision.
In contrast to SAP, the NGoggle objectively assesses peripheral loss of vision without requiring subjective input from the patient. NGoggle gauges brain activity in response to signals received from the eyes. Diminished activity may indicate functional loss from glaucoma.
The virtual reality goggles are integrated with wireless electroencephalography (EEG), a series of electrodes that adhere to the scalp to measure brain activity. Within a few minutes, the NGoggle algorithm captures and analyses enough data to report how well each eye communicates with the brain across the patient’s field of vision.
The device’s virtual reality capabilities can be greatly leveraged, Dr Medeiros said. People could be tested for glaucoma as they play a VR-based video game or explore a virtual art gallery. “The possibilities are endless for making it an engaging experience, which would go a long way toward ensuring that people use it and receive the treatment they need,” he said.

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