Mixed Reality (MR) Based Slit Lamp: The First Step Toward XR-Ophthalmology

Mixed Reality (MR) Based Slit Lamp: The First Step Toward XR-Ophthalmology | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Mixed Reality (MR) Based Slit Lamp: The First Step Toward XR-Ophthalmology Rui Zhou, Wei-Chiang Lin, Byron L Lam, Rong Wen, Noble Amadi, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7180156/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study demonstrates the concept of Mixed Reality (MR) based slit lamp (MR-SLP), which can display real-time stereoscopic diagnostic images of the eye both locally and remotely, making it suitable for stereoscopic tele-ophthalmology applications. In MR-SLP, two high-resolution video cameras were mounted on the left and right viewing channels of a conventional slit lamp to capture corresponding diagnostic images in real time, which were then transmitted to multiple MR headsets via a broadcast network. The operator wears the MR headset to see the stereoscopic diagnostic images and operates the slit lamp using the MR’s see-through function. The system's depth perception, a key feature inherited from the slit lamp, was quantitatively tested using a tube-threading task. The feasibility of tele-ophthalmology was evaluated across multiple sites with subjective feedback from participants. The results showed no observable differences in image quality or depth perception between local and remote sites, and ophthalmologists participated in this study reported a user experience with the MR-SLP that was comparable to a conventional slit lamp. Furthermore, the tube-threading test indicated that the time taken to complete the task was similar when using the MR-SLP compared to the direct view through the eyepieces. This study successfully demonstrates the feasibility of the MR-SLP for transmitting high-quality stereoscopic slit lamp images to multiple MR devices in real-time, without distance limitations, wherever an internet connection is available. Health sciences/Health care Health sciences/Medical research Physical sciences/Optics and photonics Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7180156","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":491618008,"identity":"765b2911-de1b-448f-b0b4-e648a796b15e","order_by":0,"name":"Rui Zhou","email":"","orcid":"","institution":"Florida International University","correspondingAuthor":false,"prefix":"","firstName":"Rui","middleName":"","lastName":"Zhou","suffix":""},{"id":491618010,"identity":"27b29f87-9d19-4f3b-9c47-6b7c1b8738d4","order_by":1,"name":"Wei-Chiang Lin","email":"","orcid":"","institution":"Florida International University","correspondingAuthor":false,"prefix":"","firstName":"Wei-Chiang","middleName":"","lastName":"Lin","suffix":""},{"id":491618012,"identity":"45fc1500-ae59-430d-9302-15037c7580c0","order_by":2,"name":"Byron L Lam","email":"","orcid":"","institution":"University of Miami Miller School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Byron","middleName":"L","lastName":"Lam","suffix":""},{"id":491618013,"identity":"6ccb2b8b-cccc-46c1-b168-6a454e4d5954","order_by":3,"name":"Rong Wen","email":"","orcid":"","institution":"University of Miami Miller School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Rong","middleName":"","lastName":"Wen","suffix":""},{"id":491618014,"identity":"742a9829-6b65-4cea-848f-cdc82f6b8214","order_by":4,"name":"Noble Amadi","email":"","orcid":"","institution":"Florida International University","correspondingAuthor":false,"prefix":"","firstName":"Noble","middleName":"","lastName":"Amadi","suffix":""},{"id":491618015,"identity":"845de470-9195-4dda-8ec6-5b606a583b2e","order_by":5,"name":"Shuliang Jiao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAt0lEQVRIiWNgGAWjYDACCYaEAwwMNvxsIA4PCVrSJNtI0QIChyUbiNYiP7vh4YEfFecl+CQSGB+8bSNCi8GdAwkHe87clmCTSGA2nEuUFomEhAO8bbfrgFrYpHmJ0SI/IyHh4N+2cyBb2H8TpYXhRkLCYd62AyAtbMxEaTEAaZE5kyzBxvOwWXLOOaIclpP88U2FnYR8e/LBD2/KiHEYA08ClMHYQJR6IGA/QKzKUTAKRsEoGKkAAInaNdr2e5b5AAAAAElFTkSuQmCC","orcid":"","institution":"Florida International University","correspondingAuthor":true,"prefix":"","firstName":"Shuliang","middleName":"","lastName":"Jiao","suffix":""}],"badges":[],"createdAt":"2025-07-21 18:23:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7180156/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7180156/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":98431562,"identity":"fc1892fb-f1b0-4601-92d9-a6e28a51966d","added_by":"auto","created_at":"2025-12-17 16:47:56","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1220272,"visible":true,"origin":"","legend":"","description":"","filename":"MRSLPnpjDigitalMedicineFormatedfinal.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7180156/v1_covered_236a8ecc-2544-4626-8439-f582753d6a79.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Mixed Reality (MR) Based Slit Lamp: The First Step Toward XR-Ophthalmology","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7180156/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7180156/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study demonstrates the concept of Mixed Reality (MR) based slit lamp (MR-SLP), which can display real-time stereoscopic diagnostic images of the eye both locally and remotely, making it suitable for stereoscopic tele-ophthalmology applications. In MR-SLP, two high-resolution video cameras were mounted on the left and right viewing channels of a conventional slit lamp to capture corresponding diagnostic images in real time, which were then transmitted to multiple MR headsets via a broadcast network. The operator wears the MR headset to see the stereoscopic diagnostic images and operates the slit lamp using the MR\u0026rsquo;s see-through function. The system's depth perception, a key feature inherited from the slit lamp, was quantitatively tested using a tube-threading task. The feasibility of tele-ophthalmology was evaluated across multiple sites with subjective feedback from participants. The results showed no observable differences in image quality or depth perception between local and remote sites, and ophthalmologists participated in this study reported a user experience with the MR-SLP that was comparable to a conventional slit lamp. 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