# Portable perimetry devices for glaucoma patients –practicality in daily clinical practice and glaucoma expert assessment

## TL;DR

This study compares new perimetry devices with traditional ones for glaucoma, finding that a virtual reality headset performs well in daily clinical practice.

## Contribution

The study evaluates the practicality of two novel perimetry devices in real-world clinical settings and includes expert assessments.

## Key findings

- VRP showed very high correlation with conventional perimetry for mean deviation and pattern standard deviation.
- Glaucoma experts preferred VRP over tablet-based perimetry for follow-up examinations.
- Both new methods showed good agreement with standard bowl perimetry measurements.

## Abstract

To assess the practicality of two novel perimetry devices for glaucoma in daily clinical practice: a head-mounted virtual reality headset and a tablet-based perimeter. Both were compared to conventional bowl perimetry and glaucoma experts qualitatively assessed the results.

The study included 363 eyes from 199 patients. All patients performed two perimetry examinations with one or both eyes: standard automated perimetry on a conventional bowl perimeter (CBP; Octopus 900, Haag-Streit) and subsequently one of two novel perimetry methods: virtual reality perimetry (VRP; n=100 patients; “PalmScan VF2000” MicroMedicalDevice) or tablet-based perimetry using the Melbourne Rapid Fields application (MRF; n=99 patients; Glance Optical Pty.Ltd.). Additionally, a panel of 10 glaucoma experts was asked to evaluate the new methods.

There was a very high correlation between VRP and CBP for mean deviation and pattern standard deviation (ICC 0.956 and 0.825, respectively). The correlation was moderate to high with the tablet-based perimetry using the MRF application (0.832 for mean deviation and 0.566 for pattern standard deviation). 74.6% of the surveyed glaucoma experts would recommend a follow-up examination with VRP whereas only 47.1% favored a follow-up examination with MRF.

Both novel tests closely corroborated the standard bowl perimetry measurements. The diagnostic agreement was very high for the virtual reality-perimeter and moderate to high for the tablet-based perimetry, Melbourne Rapid fields. Based on our questionnaire, most glaucoma experts would recommend a follow-up with either method with a strong preference for the virtual reality head-mounted device.

The online version contains supplementary material available at 10.1007/s00417-025-07028-9.