Clinical Optometry (Nov 2023)
At-Home Trial of Four Different Head-Mounted Displays in Visual Rehabilitation of People with Stargardt Disease
Abstract
Diana Chabané Schmidt,1 Christine Dahlgren Bohnsack Kjølholm,1 Joaquim Torner Jordana,1 Vibeke Spange,1 Pernille Duelund Højstrup,2 Bo Schack Larsen,2 Line Kessel1,3 1Department of Ophthalmology, Copenhagen University Hospital Rigshospitalet-Glostrup, Glostrup, Denmark; 2Institute for the Blind and Visually Impaired, Hellerup, Denmark; 3Department of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkCorrespondence: Diana Chabané Schmidt, Department of Ophthalmology, Copenhagen University Hospital Rigshospitalet-Glostrup, Valdemar Hansens Vej 13, Glostrup, 2600, Denmark, Email [email protected]: To examine the potential of different head-mounted displays in the rehabilitation of individuals with visual impairment.Methods: This prospective explorative study conducted between September 2019 and August 2020 included participants with Stargardt disease with moderate to severe visual impairment and a relatively preserved peripheral visual field. AceSight, eSight 3, IrisVision Live, and Jordy were tested. After instruction and training, participants chose two head-mounted displays for home use for two weeks per device. The Canadian Occupational Performance Measure was used for evaluation.Results: Twelve participants (aged 16– 53 years) tested all head-mounted displays in the clinic. Distance visual acuity and reading distance improved with all head-mounted displays and eSight and Irisvision improved near visual acuity. Six participants decided not to test the head-mounted display at home due to lack of time or energy, dizziness and discomfort, double vision and peripheral visual field limitation, or aesthetics. After home use, the participants reported improved visual function at a distance with IrisVision, AceSight, and e-Sight, whereas only AceSight improved vision during near tasks. IrisVision and eSight improved reading ability, and none of the devices improved vision during tasks involving computers. Five participants used the devices sparingly, and five avoided public use owing to aesthetics.Conclusion: We found an improvement in distance visual acuity and increased reading distance for all tested head-mounted displays. Additionally, IrisVision and eSight improved visual function at near and eSight also improved contrast vision at distance. Despite the possibility of improving vision, social stigma and device aesthetics kept the participants from using head-mounted displays in public and limited their use at home.Plain Language Summary: This study explored the potential of four different head-mounted displays for visual rehabilitation.Visual impairment not only affects daily activities but also limits participation in education, work, and social interactions.Patients with Stargardt disease tested the displays in a clinical setting and at home.We found that the head-mounted displays improved visual function. However, the patients did not wish to use the devices publicly due to social stigma and their aesthetics.The development of smaller and lighter devices that focus on aesthetics could increase usage.Keywords: head-mounted display, visual aid, visual impairment, electronic glasses, Stargardt disease
