Current Practice in Low Vision Rehabilitation of Age-related Macular Degeneration and Usefulness of Virtual Reality as a Rehabilitation Tool

Abstract

Purpose: This study surveys current low vision rehabilitation practice methodologies among French practitioners and it describes their opinions about the utility of using virtual reality as a tool for low vision rehabilitation training in patients with age-related macular degeneration.Methods: An online questionnaire was distributed between October 2017 and February 2018. 471 orthoptists (110 students and 361 graduates) responded to the survey. Questions concerned the orthoptist's educational and demographic background, extent of training in virtual reality as a reeducation tool, and mode of practice including frequency of patient visits, goals, and methods of rehabilitation training. Results:Out of 361 practicing orthoptists, 47.75% were low vision rehabilitation providers, and 52.25% were not. A provider's likelihood of using low vision rehabilitation immediately after graduating from university was positively correlated to his confidence in the training he had received. Most respondents were receptive to using virtual reality as a reeducation tool.Conclusions: Analysis of current low vision rehabilitation practice demonstrates no standardization of treatment protocols among providers. Although orthoptists overall acknowledge the benefits of virtual reality as a rehabilitation tool, orthoptist curriculum varies greatly across universities, which thus affects a provider's likelihood of offering low vision rehabilitation. Moreover, this lack of standardization is a problem worldwide, which suggests a need for better clinical guidelines in low vision rehabilitation practice.

A systematic review: Virtual-reality-based techniques for human exercises and health improvement

“…A VR program created by the VRMedLab allows users to experience visual impairments from a first-person perspective ( 71 ). The viability of using VR approaches in low vision rehabilitation was investigated in this Raphanel et al ( 72 ). One such application makes use of wall-mounted screens that show different cityscapes.…”

“…A patient can be coached to make the most of his residual visual abilities and learn new visual exploration techniques by mimicking real-world situations in VR. According to Raphanel et al ( 72 ), the patient would proceed to increasingly complicated settings, such as metropolitan streets with moving humans and cars, after becoming comfortable navigating relatively simple simulated environments. Furthermore, some orthoptists worry that patients with AMD who have binocular vision issues will not benefit from a head-mounted device since they lack 3D awareness.…”

Towards accessible news reading design in virtual reality for low vision

“…Digital devices and digital content can also be converted into an audio stream using text-tospeech software (e.g., Jaws, VoiceOver, TalkBack). For text-to-speech to function properly, the W3C Web Accessibility Initiative (WAI) 4 provides principles for creating navigable and comfortable visual design, as well as sufficient alternative text support for non-text content. Internet design and hosting services such as Shorthand (2017) are also becoming more aware to help their users integrate accessibility features early on, and authoring tools [21] can help designers visualize and evaluate the accessibility of their website design.…”

“…Nowadays, with the introduction of budget headsets such as Google Cardboard©, Oculus Go© and Samsung GearVR© 1 , the price of accessing this technology has lowered to the price of obtaining a cell phone, making VR available to the general public. Taking advantage of the freedom to visually arrange the 360 degrees visual space, VR solutions have been proposed and experimented in the context of low vision for: rehabilitation [4], navigation training [5], accessible architectural design [6], gaze pattern recording [7], and awareness raising [8]. Recent findings also show that VR offers controlled environments for conducting psychophysics user studies [9].…”