Abstract
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Purpose: To evaluate the use of a novel software application downloadable on commercially available virtual reality (VR) headset in measuring ocular tropia.
Methods: This study included 20 patients with ocular tropia. A masked ophthalmologist quantified the tropia using near and distant manual cover tests. Subsequently, each patient received a near and distant digital cover test using the Heru cover test software application (Heru, Inc, Miami) that was downloaded on a VR headset equipped with an infrared pupil tracker (Pico Neo 3 Pro Eye, ByteDance, Beijing, China). In the digital cover test, patients were instructed to maintain fixation on visual targets presented on the screen of the VR headset in front of each eye in an alternating manner, while the pupil tracker recorded the resulting eye movements. The ocular tropias measured clinically were correlated to the clinically measured ocular tropias.
Results: The clinical and digital near cover tests detected near tropia in 12 patients, while the clinical and digital distance cover tests detected distance tropia in 8 patients. The mean deviation measured clinically was 17 prism diopters (PD, ±13 PD), while that measured with the digital cover test was 13 PD (±10 PD). Tropia measured using the digital cover test very strongly correlated with the clinical diagnosis (r=0.813; P<0.001, Pearson Correlation).
Conclusion: The digital cover test in the VR headset correlates very strongly with the clinically
measured ocular tropia.
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