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Related Concept Videos

Glaucoma: Overview01:25

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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Related Experiment Video

Updated: May 3, 2026

Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
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Esterman Visual Field Testing Using a Virtual Reality Headset in Glaucoma.

Meghan Sharma1, Eleonore Savatovsky1, Laura Huertas1

  • 1Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, Florida 33136.

Ophthalmology Science
|July 29, 2024
PubMed
Summary
This summary is machine-generated.

The virtual reality visual field headset (VRVF) showed poor agreement with standard automated perimetry for the Esterman visual field (EVF) test in glaucoma patients. Further development is needed for VRVF to be a reliable tool for visual field testing.

Keywords:
Esterman visual fielddriving assessmentvirtual realityvirtual reality visual fieldsvisual field headset

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Area of Science:

  • Ophthalmology
  • Medical Technology
  • Glaucoma Research

Background:

  • Glaucoma diagnosis and monitoring rely on visual field testing.
  • Standard automated perimetry (SAP) is the current gold standard for visual field assessment.
  • Virtual reality (VR) technology offers potential for portable and accessible visual field testing.

Purpose of the Study:

  • To evaluate the efficacy of a virtual reality visual field headset (VRVF) for performing the Esterman visual field (EVF) test.
  • To compare VRVF EVF test results against standard automated perimetry (SAP) in glaucoma patients.
  • To assess the clinical utility of VRVF for determining driver's license eligibility.

Main Methods:

  • An experimental design was employed with glaucoma patients undergoing the EVF test using both SAP and VRVF.
  • Five glaucoma-trained ophthalmologists evaluated anonymized test results for pass/failure based on Florida state law.
  • Statistical analysis included point-by-point concordance (Kappa statistic) and logistic regression for pass-failure determinations.

Main Results:

  • Point-by-point concordance between VRVF and SAP was poor (κ = 0.332).
  • Concordance improved when using ophthalmologist pass-failure ratings (κ = 0.657).
  • Ophthalmologists showed higher interrater agreement for VRVF tests (κ = 0.890) compared to SAP (κ = 0.590), but VRVF had lower Esterman efficiency scores.

Conclusions:

  • The current VRVF EVF test demonstrates insufficient agreement with SAP to be a reliable determinant for driver's licensing.
  • Despite limitations, VRVF showed improved interrater reliability among ophthalmologists compared to SAP.
  • Further research and technological advancements may enable VR technology for convenient visual field testing in the future.