Performance on clinical outcomes, activities of daily living and user experience on head-mounted displays for people with vision impairment

Hilde P A van der Aa ^1,2,3, Fernanda Garcia-Piña ^1,2,3, Ruth M A van Nispen ^2,3

⁰Lighthouse Guild, New York, New York, USA.

Ophthalmic & Physiological Optics : the Journal of the British College of Ophthalmic Opticians (optometrists) +

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May 17, 2024

View abstract on PubMed

Summary

Head-mounted displays (HMDs) improved some vision tests but not real-world tasks for individuals with vision loss. Users reported dissatisfaction with device effectiveness and usability, indicating a gap between clinical performance and daily function.

Area Of Science

Ophthalmology
Human-Computer Interaction
Rehabilitation Technology

Background

Head-mounted displays (HMDs) offer potential for visual assistance in individuals with vision impairment.
Objective data on the performance, acceptance, and usability of different HMDs is crucial for effective device selection and referral.

Purpose Of The Study

To objectively compare the performance, acceptance, and usability of four leading HMDs (eSight4, Eyedaptic EYE3, Eyedaptic EYE4, IrisVision Inspire).
To provide evidence-based data to guide HMD referrals based on individual vision loss and functional needs.

Main Methods

A crossover study involving 15 adults with various eye conditions.
Assessed performance on clinical visual acuity and contrast tests.
Evaluated vision-related activities of daily living (ADLs) in Reading, Searching & Identifying, and Eye-hand Coordination categories.
Collected user-experience data and analyzed using logistic regression and ANOVA.

Main Results

All HMDs improved visual acuity; eSight4 and Eyedaptic EYE3 improved contrast tasks.
Odds of performing Reading and Searching tasks increased with HMDs, but actual performance metrics (e.g., reading speed) did not significantly improve.
Eye-hand coordination performance was equivalent to or worse than baseline with HMDs.
No demographic or clinical predictors of outcomes were found, and users reported dissatisfaction with effectiveness, acceptability, and usability.

Conclusions

While HMDs showed improvements in clinical tests, real-world ADL performance was often unchanged or diminished.
No single device universally improved all tasks, and user dissatisfaction correlated with a lack of objective functional gains.
Current HMDs may not fully meet the functional needs of individuals with vision loss despite improvements in specific visual parameters.

Keywords:

adults assistive technology head‐mounted displays vision impairment