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

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.

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.

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.

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.

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.