I was motivated to investigate virtual reality perimeters when I realized my practice was simply not performing enough visual field (VF) tests. Specifically, with our traditional perimeter, testing would sometimes be deferred until later, or declined altogether (unless it was absolutely necessary), due to a “testing room” rife with technology that made it a choking point. I knew we had to do better for our patients. 

Once we began employing a virtual reality perimeter, we were not only able to perform perimetry on all patients, we also noted the following benefits. (See “Virtual Reality Perimeter Headsets,” below.) 

Quality of care enhancement
Our virtual reality perimeter has enhanced the quality of care we provide our patients. We are now testing every patient where testing is indicated and at clinically appropriate intervals.
First and foremost, the quality of the test and its supporting scientific data (i.e., well-done validation studies) must be comparable to our standard perimeter. The virtual reality perimeter gives me repeatable, actionable data I can trust. (Clinical studies are available on each device. Reviewing them and their rigor can help to determine which device is the right fit for your practice.)

Second, it’s ergonomically comfortable for my patients to wear for the duration of the test.  
Third, the virtual reality perimeter enables us to test patients for whom traditional perimetry is not possible. Such patients include those in wheelchairs or with movement disorders; patients who have conditions that make sitting uncomfortable, and those of especially tall or short stature.

Further, virtual reality perimeters appeal to patients who may be scared or intimidated by standard perimeters. The device is light weight and adaptable to many sized faces, so even children can be easily tested.

Finally, the immersive nature of the device helps to prevent patient distractions, which may improve testing accuracy.

Efficiency/practice revenue increases
Virtual reality perimeters offer the ability to test VFs anywhere in the office and anywhere the doctor wants to bring the device.

Examples include the exam lane, the dilating area or waiting room, at a nursing home, or in a home visit. This attribute increases practice efficiency, while also enhancing practice revenue, as we can reach patients who either have physical limitations that prohibit the use of standard equipment or who are not able to make it into the office.

Happy staff
In my experience, staff acceptance of a new device is a key indicator for success. They must be comfortable with any device they are using in the clinic. Our experience has been that VR perimetry has been very easy for them to learn to use, to explain to patients, and to administer. The results from every one of our staff have been repeatable and accurate. Our VR perimeter has removed any hesitance that the staff may have had about visual field testing.

OD reputation
Perimetry is a remarkably valuable patient care tool that has remained relatively unchanged over my 30-year career.  

I believe that virtual reality perimetry has revolutionized VF testing. Moreover, adding new technology is good for our patients and our practices. Optometrists who adapt new technology are viewed by patients as “state-of-the-art” to enable them to provide stellar eye care. This perception has been shown to create patient loyalty. 

Do your homework
There are many virtual reality perimeters on the market, each with different form factors and enhancements. I recommend doing your homework on each to determine the features you may want or need. For example, devices also can include a variety of tests outside of perimetry, such as color vision and visual acuity; and they can be equipped with patient education videos.
Another example: Each device varies in weight, so wearing each one will allow you to assess how the patient may feel when wearing the device.

Further, the economic models among the available headsets vary, with different lease and purchase options. This can allow you to obtain the device in a way that makes the most financial sense for you.      

Moving to a virtual reality head-mounted perimeter has revolutionized our practice. I believe that it will do the same for you! OM 

STEPHEN M. MONTAQUILA, OD, FAAO practices at and is owner of West Bay Eye Associates, in Warwick, RI. He is a member of the American Optometric Association and the Rhode Island Optometric Association, is a Diplomate of the American Board of Optometry, and is a Fellow in the American Academy of Optometry. Additionally, he lectures nationally on topics related to eye health, contact lenses, and health care delivery reform. Disclosures: He serves as senior strategic advisor for Radius XR, and as a consultant to Glaukos.