Gaming headset could offer a win for glaucoma patients

A gaming headset is helping researchers address balance issues in patients who have glaucoma.

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A multidisciplinary group of researchers, most of whom are affiliated with the University of California, San Diego (UCSD), says it is the first to use virtual reality technology to develop new metrics to measure balance control in those with the disease. Their work, published online by the journal Ophthalmology, ultimately aims to reduce the number of falls in older adults, especially those with chronic eye disease, because they are the leading cause of injury-related death and morbidity in that population.

The investigators studied 42 patients with open-angle glaucoma; they had repeatable visual field defects on standard automated perimetry. Thirty-eight people without the disease served as controls.

Study participants wore stereoscopic goggles (Oculus Rift, Oculus VR) that simulated various settings while they stood on a “force platform.” The platform recorded torque moments around the center of foot pressure when the goggles simulated actions such as progressing through a tunnel or standing on a spinning floor. It also recorded measurements when the study participants did not wear the goggles or when the goggles were not providing visual stimulation.

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During simulated movement, researchers found, balance adjustments made by those with glaucoma were an average of 30 to 40 percent more pronounced than in the control subjects, who were able to regain balance more quickly. The authors of the cross-sectional study suspect that the pronounced lack of balance control in the participants with glaucoma may be related to the loss of retinal ganglion cells caused by the disease, which leads to slower visual processing and impaired motion perception.

The study also found that the degree to which balance was lost was strongly linked to a history of falls, evaluated from information provided on a standard questionnaire. The researchers hope that future studies using this paradigm will help ophthalmologists better understand the relationship between the risk of falls and retinal ganglion cell loss in people with glaucoma.

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The researchers found that virtual reality provided a more realistic testing environment than visual field testing, the results of which, to date, have shown only a weak correlation with fall risk in those with glaucoma, even though they have more than three times the risk of falling than people without the disease. “Measures from traditional static visual field tests do not mimic the visual conditions that occur day-to-day,” said Felipe A. Medeiros, MD, senior author as well as professor of ophthalmology and director of the Visual Performance Laboratory at UCSD. “With further refinement of this method, we hope that the approach could one day be used to identify patients at high risk of falling so that preventive measures can be employed at an earlier stage.”

Facebook co-founder and CEO Mark Zuckerberg in March 2014 announced that his company had purchased Oculus, maker to the virtual reality technology used in this study. Reports at the time valued the transaction at $2 billion U.S.

“The incredible thing about the technology is that you feel like you’re actually present in another place with other people,” Zuckerberg wrote. “People who try it say it’s different from anything they've ever experienced in their lives.” Noting that Oculus will operate independently within Facebook, he said he hopes the headset can be developed for additional 3-D gaming uses as well as additional uses.