Virtual Reality Obstacle Detection for Visual Field Loss

Overseen By Eli Peli, OD, MSc

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts Eye and Ear Infirmary

Disqualifiers: Cognitive dysfunction, Balance problems, Seizures, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 4 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new virtual reality headset designed to help people with visual field loss detect obstacles while walking. The goal is to improve mobility by expanding the user's field of view with 3D images of oncoming pedestrians. Known as the Field Expansion View, this system aims to assist those with visual field loss affecting their side vision or half of their visual field. Participants may be a good fit if they have some usable vision in their worse eye and can move short distances independently. The trial involves using the headset for sessions lasting 2-3 hours. As an unphased trial, this study offers participants the chance to contribute to innovative research that could significantly enhance mobility for those with visual field loss.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this virtual reality obstacle detection system is safe for people with visual field loss?

Research shows that using a virtual reality headset with a wider view is generally safe for people with vision loss. Studies indicate that this can help users better notice obstacles and improve their mobility.

The headset functions by displaying virtual images that expand peripheral vision. Various tests have shown that this method is well-tolerated. Available research has not reported significant negative effects directly linked to this technology.

Overall, virtual reality tools have shown promise in vision care. They are designed to be safe and easy to use. While individual experiences may vary, current research supports the safety of using VR headsets for this purpose. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the virtual reality obstacle detection approach for visual field loss because it introduces an innovative way to enhance patients' spatial awareness. Unlike traditional treatments, which often rely on rehabilitation techniques or assistive devices that don't actively change what a person sees, the field expansion view uses a head-mounted display (HMD) to overlay various configurations of expanded visual fields directly into the user's line of sight. This cutting-edge technology has the potential to improve mobility and independence by allowing individuals to better detect obstacles in their environment, which is a significant leap forward compared to existing options.

What evidence suggests that the Field expansion view is effective for visual field loss?

Studies have shown that virtual reality (VR) can help people with vision loss by widening their peripheral vision, increasing awareness of their surroundings, which is crucial for safe movement. In this trial, participants will use the Field Expansion View system. This system employs a VR headset to simulate real-life situations, such as people appearing in 3D, to help users practice avoiding obstacles. These VR methods aim to make daily activities easier and safer for those with vision problems. Early findings suggest VR could be a promising tool for improving vision in individuals with conditions like glaucoma. ^{1 2 3 6 7}

Who Is on the Research Team?

Eli Peli, OD, MSc

Principal Investigator

Senior Scientist

Are You a Good Fit for This Trial?

This trial is for people with visual field loss, such as hemianopia or tunnel vision. Participants must have binocular vision within normal limits, at least partial peripheral vision, and a visual acuity of no worse than 20/100 in the weaker eye. They should be over 14 years old, healthy enough for sessions up to 3 hours, understand English, consent voluntarily, and move independently.

Inclusion Criteria

I can walk by myself for short distances.

I can complete activities lasting 2-3 hours without significant difficulty.

I have lost vision in either half or the outer parts of my field of vision.

Exclusion Criteria

Any person with a self-reported medical history (such as pacemaker use or photosensitive epilepsy) or physical condition listed on the device manual of the Oculus / HMD system used for the experiment as a contraindication

I have had a seizure in the past 6 months.

I do not have any physical or mental disabilities that would affect my participation.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo pedestrian hazard detection tests using VR head-mounted displays with and without field expansion information

4 months

1 to 4 visits (each 2 to 4 hours)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Field expansion view

Trial Overview The study is testing a new virtual reality (VR) system designed to help individuals with visual field loss detect obstacles while walking. It involves wearing a VR headset that simulates real-world environments and oncoming pedestrians in three dimensions.

How Is the Trial Designed?

Group I: Field expansion view Experimental Treatment 1 Intervention

Various configurations of field expansion views will be additionally displayed on HMD

Who Is Running the Clinical Trial?

Massachusetts Eye and Ear Infirmary

Lead Sponsor

Trials

115

Recruited

15,000+

National Eye Institute (NEI)

Collaborator

Trials

572

Recruited

1,320,000+

Published Research Related to This Trial

A new portable visual field testing system using a VR headset (Oculus Quest 2) was developed and tested on 21 healthy subjects, showing strong agreement with traditional visual field analyzers, indicating its potential efficacy.

The VR kinetic perimetry system demonstrated good reproducibility and could provide a more accessible and portable alternative to conventional kinetic perimetry methods, which may improve patient screening in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Kinetic Perimetry on Virtual Reality Headset. Terracciano, R., Mascolo, A., Venturo, L., et al.[2023]

The Virtual Retinal Display (VRD) uses laser light to project images directly onto the retina, and safety assessments show it operates within safe power levels for normal viewing and potential failure modes.

Maximum permissible exposure (MPE) calculations confirm that the VRD is safe for users, indicating that it does not pose a risk to eye health during regular use or in case of malfunctions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Laser safety analysis of a retinal scanning display system. Viirre, E., Johnston, R., Pryor, H., et al.[2019]

The Iowa Head-Mounted Display (HMD) Open-Source Perimeter shows comparable repeatability and accuracy in detecting visual field defects when tested against the Octopus 900 perimeter in both healthy individuals and glaucoma patients, with repeatability coefficients indicating similar performance.

This new HMD system is a more portable and cost-effective alternative to traditional perimeters, potentially increasing access to visual field testing for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Validation of the Iowa Head-Mounted Open-Source Perimeter. Heinzman, Z., Linton, E., Marín-Franch, I., et al.[2023]

Virtual reality (VR) headsets for visual field testing have been shown to perform comparably or even better than traditional automated perimetry, based on a systematic review of 64 studies involving 36 different VR devices.

These VR devices are more cost-effective and better tolerated by patients, especially those with limited mobility, making them a promising alternative for visual field assessments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality headsets for perimetry testing: a systematic review. Selvan, K., Mina, M., Abdelmeguid, H., et al.[2023]

A new visual field examination method using virtual reality glasses was tested on 10 patients, showing a high correlation (r=0.808) with traditional Humphrey perimeter results, indicating its reliability.

The study suggests that this virtual reality method could be a suitable alternative for clinical use in assessing visual fields, particularly for patients in glaucoma care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visual field examination method using virtual reality glasses compared with the Humphrey perimeter. Tsapakis, S., Papaconstantinou, D., Diagourtas, A., et al.[2022]

The research developed various vision rehabilitation devices, including a head-mounted display for tunnel vision and a device for enhancing central vision, aimed at helping individuals with different types of visual impairments.

Evaluation studies were conducted with patients to assess the effectiveness of these devices, focusing on their advantages and limitations in improving visual search capabilities in controlled indoor settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and evaluation of vision rehabilitation devices. Luo, G., Peli, E.[2021]

A new Virtual Reality application has been developed to simulate various visual impairments, such as age-related macular degeneration and glaucoma, allowing users to experience the challenges faced by individuals with these conditions.

This application serves multiple purposes, including patient education and training for healthcare practitioners and eye care specialists, enhancing understanding of both normal and pathological eye anatomy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Simulation of eye disease in virtual reality. Jin, B., Ai, Z., Rasmussen, M.[2020]

The C3 field analyzer (CFA) demonstrated a higher reliability in visual field testing for neuro-ophthalmic patients, with 81.4% of tests being reliable compared to 59.3% for the traditional automated field analyzer (HFA).

CFA showed a strong correlation with HFA in detecting classic neurological field defects, such as hemianopia, with an 87.5% correlation, suggesting it could be a useful alternative for patients who struggle with standard perimetry.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of a New Head Mount Virtual Reality Perimeter (C3 Field Analyzer) With Automated Field Analyzer in Neuro-Ophthalmic Disorders. Odayappan, A., Sivakumar, P., Kotawala, S., et al.[2023]

A new virtual reality (VR) software was developed to evaluate detection abilities in the human field of regard (FOR), revealing that detection times were faster in the field of view (FOV) compared to FOR conditions, with a notable left-side attention bias observed in the FOR condition.

The study's findings suggest that understanding the unique characteristics of human perception in the FOR can inform the design of interactive 3D user interfaces, potentially benefiting individuals with FOR-related handicaps.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Human field of regard, field of view, and attention bias. Jang, W., Shin, JH., Kim, M., et al.[2017]

The base-in multiplexing prism (MxP) glasses significantly improved the ability of patients with acquired monocular vision (AMV) to detect pedestrians approaching from their blind side, providing a true field expansion of about 25°.

In a virtual reality walking environment, participants with simulated AMV showed better pedestrian detection rates when using the MxP, indicating that these glasses could help reduce collision risks for individuals with AMV.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Field Expansion with Multiplexing Prism Glasses Improves Pedestrian Detection for Acquired Monocular Vision. Jung, JH., Castle, R., Kurukuti, NM., et al.[2023]

Current VR headsets have a minimum angular resolution of 0.41 logMAR on average, which is inadequate for reliable visual acuity testing and may not be suitable for treating conditions like amblyopia.

The average field of view for VR headsets is about 50.2°, which is significantly lower than manufacturer claims, but it may still be sufficient for certain visual field tests, although concerns exist for vergence testing due to varying eye-to-screen distances.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measuring Virtual Reality Headset Resolution and Field of View: Implications for Vision Care Applications. Lynn, MH., Luo, G., Tomasi, M., et al.[2021]

A new virtual reality (VR) walking collision detection test was developed using the Meta Quest 2 headset, allowing subjects to physically walk in a simulated busy shopping mall environment to assess their ability to detect and avoid collisions.

This VR platform addresses safety and consistency issues found in real-world obstacle courses, making it a promising tool for evaluating clinical interventions related to mobility and collision avoidance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of Virtual Reality Walking Collision Detection Test on Head-mounted display. Hwang, AD., Peli, E., Jung, JH.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7002244/

Expansion of Peripheral Visual Field with Novel Virtual Reality ... These novel spectacles may enhance peripheral objects awareness by enlarging the functional field of view in glaucoma patients.

2. withpower.com withpower.com/trial/phase-hemianopsia-2022-681a9

Virtual Reality Obstacle Detection for Visual Field Loss This trial uses a VR headset to help people with visual field loss practice detecting and avoiding virtual pedestrians.

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05141604

Feasibility Test of Virtual Reality Obstacle Detection for ... The investigators are developing a new test of pedestrian hazard detection in virtual reality (VR) head-mounted display (HMD) headset, which shows virtual ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0966636221000229

Effects of wearing a head-mounted display during ... Wearing an HMD affected TUG performance in younger and older adults, which should be considered when an HMD is used for VR applications in rehabilitation.

5. medrxiv.org medrxiv.org/content/10.1101/2025.05.20.25327918v1.full-text

A Rapid Review of the Use of VR as a Tool in Vision Care This rapid review evaluates and characterizes the existing literature on VR technologies for diagnosing and treating vision-based diseases.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5580828/

Head-Mounted Display Technology for Low Vision ... To describe the various types of head-mounted display technology, their optical and human factors considerations, and their potential for use in low vision ...

7. mdpi.com mdpi.com/2227-7080/13/8/342

A Rapid Review of the Use of VR as a Tool in Vision Care (1) Virtual reality (VR) technologies have shown significant potential for diagnosing and treating vision-related impairments. This rapid review evaluates ...