Comprehensive eye exam in the emergency department using an AI-assisted virtual reality platform

The high demand in ophthalmology emergency departments (ED) requires the improvement of protocols to ensure accurate diagnosis without prolonged waiting times. This study aims to evaluate the performance of a virtual reality platform (VRP) in assessing the visual functions of patients, compared to a traditional ophthalmic exam, in an ophthalmology ED.

Fifty cognitively intact adult patients were recruited from the ophthalmology ED. A battery of tests, including visual acuity (VA), color vision, pupil examination, suprathreshold screening visual field, and extraocular motility, was conducted using the VisuALL VRP and the standardized ophthalmic exam. Testing time, prior experience with virtual reality, and a satisfaction questionnaire were also collected.

Out of 50, 48 patients completed the full examination with the VRP. The mean time taking the tests with the VRP was 5.65 ± 1.57 min. A significant positive correlation existed between VA measured with the VRP and the traditional exam (r = 0.457, P < 0.0001). All pupillometry measurements showed a moderately significant correlation between methods with intraclass correlation coefficients ranging from 0.671 (95 % CI [0.41-0.82], P = 0.0001) to 0.753 (95 % CI [0.55-0.86], P < 0.0001). The agreement between the standard method and the VRP across all eye gaze positions ranged from 94 % to 100 %, particularly when the movement was full. The visual field testing exhibited an agreement between 96 % and 100 %, mostly when no defects were present. Seventy-six percent of participants considered the VRP easy to use, and 72 % felt just as comfortable using the VRP as the standard workup.

Implementing a novel VRP in an ophthalmology ED is feasible and well-accepted, representing a significant step toward broader VR use in this setting. It has the potential to improve patient satisfaction and enhance clinical workflow in the emergency department of a tertiary eye care facility.