A study to assess the feasibility of utilising virtual reality for the treatment of accommodative and vergence infacility

Background: To assess the feasibility, as well as viability, of utilising gaming using virtual reality (VR) to treat accommodative and vergence infacilities. Methods: Forty-two emmetropic and asymptomatic participants between the ages of 18 and 30, with normal binocular visual function, were selected for the study in 2018. Participants with binocular accommodative infacilities and/or vergence infacilities comprised the study population. The binocular accommodative facilities (BAF) were assessed using amplitude-scaled facilities (probe lens = 30% amplitude of accommodation; test distance = 45% amplitude of accommodation). All those with less than 10 cycles per minute (cpm) were regarded as failing. Vergence facilities were assessed using 12 pd base out and 3 pd base in prisms. All those with less than 15 cpm were regarded as failing. The participants were separated into age-matched experimental and control groups. The experimental group played a fast-paced game using Samsung Gear VR (SM-R323), whilst the control group watched a television film projected onto a two-dimensional screen at a distance of one metre. Pre-test and post-test binocular amplitude-scaled facilities and vergence facilities were measured for both groups after exposure for 25 minutes. Results: There was a significant, mean increase in binocular accommodative facilities of 4.67 ± 5.05 cpm (p = 0.008) for the experimental group (n = 12). There was a significant mean increase in vergence facilities of 3.72 ± 3.18 cpm (p < 0.001) for the experimental group (n = 32). A statistically significant mean difference of 4.07 cpm (95%CI: 0.97, 9.19; p = 0.03) between the respective control and experimental groups was found for binocular accommodative facilities and 2.45 cpm (95%CI: 0.68, 4.22; p = 0.008) for vergence facilities. Conclusion: Binocular accommodative facilities and vergence facilities increased after 25 minutes of VR gaming in asymptomatic emmetropic participants with accommodative infacilities and vergence infacilities. However, due to the small-scale, unmasked and unrandomised nature of the study more research is needed to confirm the results of this study.