Optometry's Meeting

Optometry's Meeting

June 23, 2017
3 min read

Virtual, augmented reality have role in training, treatment

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WASHINGTON – Virtual reality and augmented reality technologies are being used for training in schools of optometry as well as for treatment of ocular conditions such as amblyopia and strabismus, according to a panel here at Optometry’s Meeting.

Kyle Sandberg, OD, FAAO, an instructor at the Rosenberg School of Optometry, demonstrated how the EyeSi by VR Magic is being used at the school as a binocular indirect ophthalmoscope (BIO) simulator.

Sandberg said in 2015, 25.4% (17 out of 63) of the students failed BIO assessment.

“After we instituted the EyeSi in 2016, only 7.4% failed – five out of 67 students,” he said. “This type of technology is helping a lot.”

ZSpace simulators are used in anatomy lab, he continued. With Cyber-Anatomy, a 3-D view of the eye is presented, and the student can use a stylus to select and move parts of the eye. In addition, EyeSi has another technology that simulates cataract surgery.

James Blaha, CEO and co-founder of Vivid Vision, said this technology “brings virtual reality to optometric clinics all over the world” for vision therapy and sports vision training.

Blaha said he was diagnosed with strabismus and amblyopia as a toddler. After trying standard treatments such as patching and atropine drops unsuccessfully, his doctor told him he was too old to be treated at the age of 9 years.

Four years ago Blaha got an Oculus Rift virtual reality headset and made a prototype of a device to treat his amblyopia.

“There’s a cube 1 meter in size that spins out in front of you,” he explained. “I was able to increase the brightness to my amblyopic eye and decrease the brightness to the other eye. All of a sudden, my amblyopic eye turned on, and I could see much better. I had stereopsis for the first time in my life.”

Brian Dornbos, OD, a clinical advisor to Vivid Vision, explained that during this type of treatment, “the patient needs to be able to relax accommodation, but also converge and diverge their eyes while accommodation does not change.”

He said use of the technology brings with it issues such as blue light exposure and decreased blink rate and the resulting dry eye.

Tuan Tran, OD, chief optometrist and co-founder of Vivid Vision, said, “Imagine if you could put a headset on a child and let them play a video game and treat their amblyopia. We are doing this. Using a split screen, it forces the patient to use both eyes. You can control the program to break the patient’s suppression of their bad eye.”


Tran brought a woman from the audience who claimed to have amblyopia onstage to demonstrate the use of the Vivid Vision technology. Attendees were able to view on the large screens what the patient was seeing, while hearing her provide feedback on what she visualized. Tran’s adjustments to the appearance of the test were also visible on the screen.

Margo Adams Larsen, PhD, a psychologist who specializes in pediatric health care, and research director for Virtually Better Inc., a group of psychologists and designers that creates virtual reality applications for behavioral health care, explained how virtual and augmented reality are being used in training and treatment in her field.

Virtual reality is a computer-generated environment intended to replicate an experience, she said.

She noted that “building out that experience” involves adding sensory components to it such as tactile feedback, auditory input and olfaction.

“We end up with a well-rounded virtual experience that can feel quite real,” Adams Larsen said.

“Augmented reality is based on intelligent technologies that enhance the user’s current perception of reality, while virtual reality replaces the user’s real world with a simulated representation,” she added.

Necessary components include a keyboard, monitor, head-mounted display, headset with microphone, scent machine and sensory platform, which can vibrate.

“There’s a lot of wasted time in both training and practice settings,” Adams Larsen said. “Using virtual reality and augmented reality can really cut those times down. Maybe our training time is the same amount, but the experience we’re cramming into that is exponentially impacting our learning. We’re seeing that in student pass rates in terms of using these technologies.”

In the field of psychology, virtual reality is used to treat anxiety, post-traumatic stress disorder, substance abuse, and fear of flying, heights, public speaking and storms.

“These all require an exposure experience and, thus, lend themselves well to the addition of virtual reality modalities,” she said.

She showed a video of a patient being treated for alcohol abuse, where the patient wears a virtual reality headset and virtually experiences walking into a bar and can share how she feels and plans on handling the situation. The clinician can see what the patient is seeing and control it as well as communicate with her. – by Nancy Hemphill, ELS, FAAO


Blaha J, et al. OD Talks: Virtual and augmented reality. Presented at: Optometry’s Meeting; Washington; June 21-June 25.

Disclosures: Sandberg and Adams Larsen reported no relevant financial disclosures. Blaha is CEO and co-founder of Vivid Vision. Dornbos is an advisor to Vivid Vision. Tran is chief optometrist and co-founder of Vivid Vision.