ESCRS - FP28.12 - Advancing Glaucoma Care Through Virtual Reality: Comparative Performance Of Virtual Reality-Visual Field Testing And Humphrey Perimetry

Advancing Glaucoma Care Through Virtual Reality: Comparative Performance Of Virtual Reality-Visual Field Testing And Humphrey Perimetry

Published 2026 - 44th Congress of the ESCRS

Reference: FP28.12 | Type: Free paper | DOI: 10.82333/d8r7-ze86

Authors: Mr Abiram Chandiramohan* 1 , Ms Liv Lovering 1 , Ms Victoria Iannetta 1 , Dr Abdullah Sarhan 2 , Mr William Herspiegel 1 , Dr James Armstrong 1 , Dr Cindy Hutnik 1 , Dr Tal Sharon 1

1Western University,London,Canada, 2RetinaLogik,Calgary,Canada

Purpose

Glaucoma is a leading cause of irreversible blindness, and its effective management depends on timely, reliable visual field (VF) assessment. The Humphrey Visual Field (HVFA) analyzer remains the clinical standard but is limited by cost, accessibility, and patient discomfort. Virtual reality–based perimetry offers a portable, patient-friendly alternative. This study evaluates the accuracy, reliability, feasibility, and user experience of the Canadian-developed RetinaLogik VR Visual Field (VR-VF) compared with HVF across varying stages of glaucoma.

Setting

This study was conducted at the Ivey Eye Institute, London Ontario, Canada.

Methods

This single-center study was conducted at the Ivy Eye Institute London Ontario. Participants ranging from  healthy controls to advanced glaucoma did 25-2C Fast on both the HFA and the RVF200 (Retinalogik Inc, Canada). The primary outcomes were Mean Deviation (MD), Pattern Standard Deviation (PSD), Visual Field Index (VFI), and numerical sensitivity plots. Statistical analyses included Pearson correlations, paired comparisons, and Bland–Altman plots. Test duration and operational metrics were recorded.

Results

Thirty-nine participants with various stages of glaucoma (mean age 68 years; 21 female) contributed 68 eyes (35 OD, 33 OS). Mean deviation (MD) values were comparable between devices (VR-VF: –4.89 dB; HVF: –3.8 dB). VR-VF demonstrated strong correlation with HVF for MD (r=0.96), PSD (r=0.93), and mean sensitivity (r=0.96). Bland–Altman analysis for mean sensitivity showed a bias of 1.35 dB with 95% limits of agreement of –1.96 to +1.96 dB. Average test durations were similar (VR-VF 3.35 min vs HVF 3.32 min). 

Conclusions

Preliminary findings demonstrate excellent concordance between VR-VF and HVF, with comparable test times and strong patient acceptance. VR-based perimetry shows promise as a reliable, accessible alternative for glaucoma monitoring, supporting its integration into clinical and remote care settings.