Eyeworld

SUMMER 2025 | EYEWORLD | 71 G CHANGING MINDSETS j ames T. Murphy, MD, began using virtu- al visual fields in his glaucoma practice in 2020 as a pandemic necessity. Lori Provencher, MD, incorporated virtual visual fields over a year ago when she switched practices. "I can't imagine going back," Dr. Provencher said, noting that when she joined Vance Thomp- son Vision in Omaha, Nebraska, the practice already had a standard Zeiss Humphrey Visual Field Analyzer but had decided to invest in three Radius VR headsets. The latter are now her preference. "Clinically, Radius has a testing strategy, RATA, that is similar to SITA, and it has excellent correlation with HFA when staging disease. It has also been studied in all ranges of disease severity, which gives me confidence us- ing it in a diverse glaucoma practice. The back- ground luminance is also the same as the HFA, an important detail that is missed with other virtual field devices. For patients, the headset is light, comfortable, ergonomically superior to bowl perimetry, and easy to use. Patients don't have to shuffle from room to room. My team loves Radius as well. They find it easy to use, and they love that it eliminates the bottleneck waiting for an HFA. From a practice perspective, educational videos, billing data, and easy soft- ware updates are also a value add." Dr. Murphy said his practice brought in the technology because it allowed them to conduct virtual visual fields with patients in their car when pandemic social distancing measures were in place. "We handed it to them outside in the parking lot," he said. "It worked really well to continue to monitor glaucoma patients. Then we thought, 'We could use these forever.'" Dr. Murphy said he's found virtual visual fields versatile and well-liked by patients. There is also an audio coaching aspect with different languages, which he has found useful. Dr. Murphy said the ergonomic features of virtual visual field technology are an advantage as well. Whether it's a patient who is wheel- chair bound, one who has neck issues, or one who just cannot maintain the position required for taking visual fields with a tabletop device accurately and reliably, virtual visual fields have come to the rescue. Dr. Murphy said he has demoed various virtual visual field devices, such as Radius and Olleyes. "I've dabbled over the years because I've been curious about how the technology is evolving and improving," he said. While virtual visual field use is not ubiq- uitous within ophthalmology practices, Dr. Murphy said he thinks 5 years from now it will "100% be standard of care." "I liken virtual field testing to when Hum- phrey superseded kinetic Goldmann field testing," he said. "Nowadays it is impossible to find a technician who can run a Goldmann. Inevitably, new, better, more efficient technol- ogy replaces the old. At first, there are always skeptics, but eventually practicality wins, and the standard of care evolves." Dr. Murphy thinks there will be a gradual shift in the market, and an HFA will become less common to find in private practice, and more so one will see virtual reality wearable devices administering automated perimetry. As this shift occurs, he thinks that research standards will evolve to accommodate this change in technolo- gy prevalence. For those who have not yet switched to virtual visual fields, Dr. Murphy said they have to try it, and he noted that it is billable the same as HFA or any automated perimetric device that tests and maps sufficient isopters or performs similar quantitative analysis of the field of vision. "Virtual devices perform the same testing as an HFA, but they are a fraction of the size About the physicians James T. Murphy, MD Scarsdale Ophthalmology Associates Scarsdale, New York Yvonne Ou, MD Professor, Vice Chair for Postgraduate Education Department of Ophthalmology University of California, San Francisco San Francisco, California Lori Provencher, MD Vance Thompson Vision Omaha, Nebraska Relevant disclosures Murphy: None Ou: NEI-funded Vivid Vision Provencher: Radius by Liz Hillman Editorial Co-Director Experience with virtual visual fields for glaucoma continued on page 72 The RadiusXR VR headset allows for a comfortable VF experience for the patient and a streamlined workflow for the technician and doctor, according to Dr. Provencher. Source: RadiusXR

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