Session: Poster session A

Arkus Vision: a new method for the assessment and quantification of diplopia with virtual reality

Ana MOLEIRO¹, Silva RENATO ¹, Pereira ANA CRISTINA¹, Fernandes HUGO², Magalhães AUGUSTO¹

¹Department of Ophthalmology, São João University Hospital, Porto, Portugal
²Faculty of Engineering of University of Porto, Porto, Portugal

INTRODUCTION:

Diplopia, or double vision, arises when eyes are misaligned, causing the perception of two images of a single object in the same visual space. This misalignment can be horizontal, vertical, or torsional, often involving multiple spatial planes. Surgical planning for diplopia necessitates the study and quantification of deviations. Classical methods include the use of red glass, Maddox rods, and Worth lights, coordimetry, synoptophore, and synoptometer. Drawbacks of these methods include image dissociation, the inability to measure deviation in diagnostic visual field positions, and limitations in evaluating deviation with fixation at different distances.

METHODS:

Description and practical application of software using virtual reality GOOGLES to address the limitations of classical methods for quantifying deviations in patients with diplopia. The application is integrated into the storage unit of virtual reality glasses (Oculus Quest 2; 256 GB) and communicates remotely with a server that stores, analyzes, and builds a report of the generated information.

RESULTS:

The software analyzes and quantifies deviation up to 30° in nine cardinal positions of the visual field, both horizontally and vertically, without eye image dissociation. It measures torsional deviation in all positions, being configurable for various fixation distances. Reports offer unlimited customizable graphs, reflecting "patient's view" and "observer's view" preferences. The system regulates head position and measures torticollis in sagittal and transverse planes, with presented paradigmatic cases highlighting method's importance.

CONCLUSIONS:

The application (software) represents an innovative, facilitating, and optimizing technology for the evaluation and quantification of ocular deviations in patients with diplopia and normal retinal correspondence. The method has proven to be of utmost importance in the study and surgical planning of complex strabismus cases with diplopia.