Evaluation of an Augmented-Reality Head-Mounted Display Among Patients With Glaucomatous Tunnel Vision

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Purpose: The purpose of this study was to evaluate the effectiveness of an augmented-reality (AR) head-mounted display (HMD) in patients with glaucomatous tunnel vision. Methods: Fifteen patients with glaucoma with a central visual field (VF) of less than 20 degrees in radius in their better eye and 15 healthy controls were enrolled. Patients completed visual function (kinetic VF, contrast sensitivity [CS], and visual acuity [VA]), visual search, and mobility tests with and without the device. For initial validation of the performance-based tests and the device, a perforated eye mask was used to simulate the peripheral field loss (PFL) in healthy controls. Results: The VF area of the better eye significantly increased when patients used the device (P <0.001). Better-eye CS improved with the device in both normal (P < 0.001) and contrast modes (P = 0.014). Better-eye VA did not significantly improve with device use. Similar results were observed in patients' worse eyes. A significant reduction in average search time was observed when patients used the device (P = 0.001), whereas the task scores did not significantly change. The average walking time was prolonged with device use (P = 0.001), whereas obstacle avoidance scores showed no significant differences. Comparable test results were demonstrated in both healthy controls and subjects with simulated PFLs. Conclusions: The AR HMD significantly improved the VF, CS, and visual search performance of patients with glaucomatous tunnel vision, but it did not improve patients' VA and mobility performance. Translational Relevance: These findings provide evidence for the potential of AR-based devices in vision rehabilitation and may offer insights for the future optimization of such technologies.

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