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Seeing other perspectives: Evaluating the use of virtual and augmented reality to simulate visual impairments (OpenVisSim)

Jones, P. R. ORCID: 0000-0001-7672-8397, Somoskeöy, T., Chow-Wing-Bom, H. & Crabb, D. P. ORCID: 0000-0001-8754-3902 (2020). Seeing other perspectives: Evaluating the use of virtual and augmented reality to simulate visual impairments (OpenVisSim). NPJ Digital Medicine, 3(32), doi: 10.1038/s41746-020-0242-6


Simulations of visual impairment are often used to educate and inform the public. However, evidence regarding their accuracy remains lacking. Here we evaluated the effectiveness of modern digital technologies to simulate the everyday difficulties caused by glaucoma. Twenty5 three normally-sighted adults performed two everyday tasks that glaucoma patients often report difficulties with: a visual search task in which they attempted to locate a mobile phone in virtual domestic environments (Virtual Reality; VR), and a visual mobility task in which impairments were overlaid onto a real-world environment using Augmented Reality (AR). On some trials, a gaze-contingent simulated scotoma --- generated using perimetric data from a patient with advanced glaucoma --- was presented in either the superior or inferior hemifield. The main outcome measure was task completion time. Eye and head movements were also tracked and used to assess individual differences in looking behaviors. The results showed that the simulated impairments substantial impaired performance in both the VR (visual search) and AR (visual mobility) tasks (both P < 0.001). Furthermore, and in line with previous patient data: impairments were greatest when the simulated VFL was inferior versus superior (P < 0.001), participants made more eye and head movements in the inferior VFL condition (P < 0.001), and participants rated the inferior VFL condition as more difficult (P < 0.001). Notably, the difference in performance between the inferior and superior conditions was almost as great as the difference between a superior VFL and no impairment at all (VR: 71%; AR: 70%). We conclude that modern digital simulators are able to replicate and objectively quantify some of the key everyday difficulties associated with visual impairments. Advantages, limitations and possible applications of current technologies are discussed. Instructions are also given for how to freely obtain the software described (OpenVisSim).

Publication Type: Article
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit
Publisher Keywords: Visual impairment, Visual Field Loss, Glaucoma, Accessibility, Urban Design, Health Economics, Virtual Reality, Augmented Reality
Subjects: R Medicine > RE Ophthalmology
Departments: School of Health & Psychological Sciences > Optometry & Visual Sciences
Text - Published Version
Available under License Creative Commons Attribution.

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