Using Virtual Field to Make Visual Field Exams Accessible

As you know, accurate measurement of the visual field is crucial for diagnosing and managing various eye diseases, including glaucoma, stroke, and brain tumors. However, traditional tabletop perimeters often pose accessibility challenges for patients with wheelchairs, limited mobility, or visual impairments. Recognizing the need for an inclusive solution, Virtual Field (VF) emerged in 2018 utilizing virtual reality (VR) headsets to offer a more accessible and more comfortable alternative to traditional testing methods.

This article delves into the key advantages of Virtual Field and explores Virtual Field’s potential to improve patient compliance and diagnostic accuracy, ultimately fostering a more equitable and effective healthcare experience for all.

Virtual Field is a company that was founded in 2018. Our providers have run more than 1.5 million exams. 

Traditional Tabletop Perimeters

Traditional tabletop perimetry is a standard method for assessing the visual field in ophthalmic examinations. This technique involves the use of a static perimeter where patients focus on a central fixation target and respond to visual stimuli presented at various locations within their visual field. The perimeter utilizes a grid pattern to systematically test different areas of the visual field, providing valuable information about potential visual field defects.

While traditional tabletop perimeters are a mainstay in ophthalmic practice, they can present certain limitations in terms of patient experience and accessibility. For example, the fixed chin and headrest of tabletop perimeters require patients to maintain a specific posture for extended periods, which can be difficult or even impossible for those with limited neck, back, or arm mobility. These challenges can compromise the accuracy of results, potentially leading to incomplete or unreliable data.

Device usage can also cause discomfort. For example, prolonged chin and forehead rest contact can be uncomfortable, and the enclosed nature of the perimeter can induce anxiety or claustrophobia in some patients, further impacting their ability to focus and participate effectively. 

It’s important to note that logistical challenges may also arise. The bulky size and fixed positioning of tabletop perimeters limit accessibility for wheelchair users and individuals requiring additional support. Furthermore, the test setup and patient instructions can require significant technician time, sometimes up to 10 minutes, impacting clinic efficiency.

Virtual Visual Field Headsets

Virtual visual fields represent a technological advancement in visual field testing, offering a dynamic alternative to traditional tabletop perimetry. Similar to traditional visual fields, patients respond to stimuli by clicking a button on a controller. However, there are many notable differences that improve the doctor, technician, and patient experience. 

Accessibility Features

When comparing traditional tabletop perimeters to virtual reality perimeters, virtual visual field headsets offer unique advantages for patients with mobility issues. Here are some common accessibility features realized with Virtual Field:

• Portable and lightweight: Compact headsets eliminate the need for bulky equipment and dedicated testing rooms, facilitating examinations in wheelchairs or at bedside.
• Voice guidance: Audio instructions provided in the patient’s native language simplify the setup process. Patients will also receive corrections and encouragements in their native language which improves compliance. Virtual Field, in particular, offers 38 languages.
• Adjustable testing positions: Unlike tabletop analyzers, Virtual Field headsets accommodate various seating positions, including wheelchairs, walkers with seats, and recliners.
• Testing in rural areas: Virtual Field only requires a WiFi connection and a device such as a desktop computer, laptop, iPad, or even a smartphone to run an exam. Many doctors in rural areas use Virtual Field to test patients who wouldn’t otherwise have access to proper care. Results can also be reviewed and accessed from remote locations for quick and efficient treatment and diagnosis. 
• User-friendly: The user-friendly experience begins with easy setup and operation for patients. Virtual Field, in particular, offers an intuitive interface, reducing the complexity of the testing process and minimizing the need for extensive training. There is even the ability to queue multiple exams in a row on Virtual Field. 

Advantages for Patients with Mobility Limitations

Virtual visual field headsets offer significant accessibility improvements and advantages for patients with wheelchairs and mobility limitations. Some of the most common advantages include:

• Reduced physical strain: Virtual Field eliminates the need for chin and forehead rests, minimizing physical strain and fatigue. The need to relocate out of a wheelchair or other seated aids is eradicated. 
• Increased comfort: Testing positions with Virtual Field can be customized to accommodate specific needs and comfortability, potentially reducing anxiety and stress associated with traditional testing.
• Improved compliance: The ease of use and reduced discomfort may encourage better adherence to testing protocols, leading to more accurate diagnoses.

Eyecare professionals should consider virtual visual field technology to enhance patient comfort, compliance, and diagnostic accuracy.

Real-world Virtual Field Success Stories

Many ophthalmologists, surgeons, and other eye care professionals have found success using Virtual Field in their practices. Here are just a few case studies that highlight their success with Virtual Field.

Case Study: Dr. Dimitrios Sismanis: Dr. Sismanis, an oculoplastic surgeon specializing in oculoplastic and reconstructive surgery, said that using Virtual Field technology like the Superior 36 and 30-2 BOLT exams has been a game-changer. 

In a case study, Dr. Sismanis highlighted how Virtual Field technology addressed key challenges in ophthalmic care: streamlining insurance approvals through reliable automated testing, simplifying data presentation, and enhancing patient care through real-time monitoring and improved comfort. 

He found the Virtual Field subscription model cost-effective and praised its impact on both patient outcomes and practice efficiency.

Case Study: Dr. Jonathan Kahn: Dr. Kahn is an ophthalmologist specializing in cornea, cataract, and refractive. He discussed his positive experience with Virtual Field technology in a case study featuring 24-2 BOLT and 10-2 BOLT exams. 

Recognizing practice inefficiencies, Dr. Kahn implemented Virtual Field to streamline testing processes, resulting in increased patient engagement and accessibility. The technology's impact on patient satisfaction was evident, with reduced complaints and greater ease during testing. Virtual Field's portability allowed flexibility in test administration, even in unconventional spaces. 

Dr. Kahn highlighted improvements in workflow efficiency, reducing appointment wait times, and providing a smoother scheduling process. Additionally, Virtual Field's advancements in data interpretation, software quality, and report formatting contributed to an enhanced user experience, facilitating a more efficient and enjoyable patient journey for both clinicians and patients alike.

Case Study: Dr. Carly Seidman: Dr. Seidman, an ophthalmologist and medical retina specialist, shared a transformative case study on the impact of Virtual Field in her ophthalmology practice, utilizing 24-2 BOLT and 10-2 BOLT exams. 

Virtual Field addressed the challenges that Dr. Seidman faced with limited office space, providing a flexible and efficient testing option. She has achieved outstanding results using Virtual Field for glaucoma monitoring and hydroxychloroquine screenings. She also noted that the technology's ptosis examination has aided in insurance prior authorizations for blepharoplasties.

In conclusion, Virtual Field addresses longstanding challenges associated with traditional methods of visual field testing. By leveraging lightweight headsets, an easy-to-understand user interface, a customer success team, and a community, Virtual Field not only enhances accessibility and comfort for patients but also streamlines testing processes and improves diagnostic accuracy for healthcare professionals. Real-world case studies underscore the tangible benefits of Virtual Field in enhancing patient outcomes and practice efficiency. As Virtual Field continues to evolve, the company solidifies its role in fostering a more equitable and effective eye care experience, ensuring that all individuals, regardless of mobility limitations or visual impairments, continue to benefit from the highest standard of care.