VisualR: a novel and scalable solution for assessing visual function using virtual reality

Background Diagnosis and treatment of progressive eye diseases require effective monitoring of visual structure and function. However, current methods for measuring visual function are limited in accuracy, reliability, and usability. We propose a novel approach that leverages virtual reality (VR) technology to overcome these challenges, enabling more comprehensive measurements of visual function endpoints. Results We developed VisualR, a low-cost VR-based application that consists of a smartphone app and a simple VR headset. The virtual environment allows precise control of visual stimuli, full control over the field of view, separating visual input to the left and right eyes, controlling visual angles and blocking background visual noise. We developed novel tests for metamorphopsia, contrast sensitivity and reading speed that can be performed by following simple instructions and providing verbal responses to visual cues, without the need for expert supervision. The smartphone app does not require an internet connection, handles all data processing and image display, and all data is stored locally and owned by the user. Conclusion VisualR demonstrates the feasibility of building a visual function test device using consumer-grade hardware. Eventually, this technology could be used to measure visual function endpoints during clinical development of new treatments and to support disease diagnosis and monitoring. We open-sourced the application code and provide guidelines for creating reliable and user-friendly VR-based tests. We believe VR can open a new paradigm in visual function testing, and invite the wider community to build upon our work.