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Published on: March 10, 2021
Use of a Virtual Reality Visual Field Device to Improve Quality of Care in the Emergency Department and Inpatient
Aileen G MacLachlan1, Cameron M Carpenter, Natalie K Modersitzki
1University of Utah (AGM, CMC, MDS), Spencer F. Eccles School of Medicine, Salt Lake City, Utah; University of Utah (NKM), Salt Lake City, Utah; Department of Ophthalmology and Visual Sciences (AVC, KBD, BJK, SV, JEAW, TML, MDS), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah; and Department of Neurology (AVC, KBD, BJK, SV, JEAW, MDS), University of Utah, Salt Lake City, Utah.
Background:
Automated visual field testing is an essential diagnostic and disease monitoring tool for many neuro-ophthalmic disorders. Most commonly, automated devices are stationary and located in ophthalmology clinics. Thus, formal visual field testing has been limited in the hospital setting until recent availability of virtual reality visual field testing. In this study, we report our experience with the use of a virtual visual field (VVF) device in the Emergency Department (ED) and inpatient hospital settings.
Methods:
We performed a retrospective chart review of our use of a VVF device in the ED and inpatient hospital setting from February 2020 to September 2022. We report our experience and the impact on patient care with use of the VVF device.
Results:
One hundred fifty patients (aged 10-85 years) and 162 visual field encounters were identified. Patients were most commonly located on the regular hospital ward (51%), followed by the intensive care unit (28%), and ED (21%). The VVF prevented the need for a trip to the outpatient ophthalmology clinic in 100% of encounters of patients with vision-threatening papilledema. Use of the VVF provided a more detailed, baseline examination at bedside in 61% of all encounters. A bedside pre- and postoperative visual field assessment was achieved in 14% of encounters. The VVF changed management in 70% of encounters.
Conclusions:
In our experience, use of the VVF has improved the quality of care for inpatients with neuro-ophthalmic conditions. A significant impact of the VVF was increased safety by preventing the need to transport patients to the outpatient setting for visual field monitoring, especially patients with vision-threatening papilledema and lumbar drains. The VVF made formal visual testing available to patients with mobility restrictions and patients undergoing neurosurgical procedures. Owing to improvement in quality of patient care, the VVF analyzer has become a mainstay of the examination of patients in the ED and hospital.
